| National Provider Identifier [NPI]: | 1871661041 |
| Last Name Of The Provider | UTHAMAN |
| First Name Of The Provider | UDAY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 249 E MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWARK |
| Zip Code Of The Provider | 197117317 |
| State Code Of The Provider | DE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 2675 |
| Number Of Medicare Beneficiaries | 255 |
| Total Submitted Charge Amount | 697152.45 |
| Total Medicare Allowed Amount | 223789.66 |
| Total Medicare Payment Amount | 165110.74 |
| Total Medicare Standardized Payment Amount | 161089.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 114 |
| Number Of Medicare Beneficiaries With Drug Services | 59 |
| Total Drug Submitted ChargeAmount | 1032.85 |
| Total Drug Medicare AllowedAmount | 421.46 |
| Total Drug Medicare PaymentAmount | 327.34 |
| Total Drug Medicare Standardized Payment Amount | 327.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 2561 |
| Number Of Medicare Beneficiaries With Medical Services | 255 |
| Total Medical Submitted Charge Amount | 696119.6 |
| Total Medical Medicare Allowed Amount | 223368.2 |
| Total Medical Medicare Payment Amount | 164783.4 |
| Total Medical Medicare Standardized Payment Amount | 160762.18 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 167 |
| Number Of Beneficiaries Age 65 to 74 | 66 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 144 |
| Number Of Male Beneficiaries | 111 |
| Number Of Non Hispanic White Beneficiaries | 174 |
| Number Of Black or African American Beneficiaries | 66 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 119 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 136 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 67 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4437 |