| National Provider Identifier [NPI]: | 1639164965 |
| Last Name Of The Provider | UTHOFF |
| First Name Of The Provider | FRED |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1019 N MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | SIKESTON |
| Zip Code Of The Provider | 638015043 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 4332 |
| Number Of Medicare Beneficiaries | 776 |
| Total Submitted Charge Amount | 621824.94 |
| Total Medicare Allowed Amount | 324962.72 |
| Total Medicare Payment Amount | 233370.46 |
| Total Medicare Standardized Payment Amount | 251248.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 334 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 7160.75 |
| Total Drug Medicare AllowedAmount | 1391.77 |
| Total Drug Medicare PaymentAmount | 1141.02 |
| Total Drug Medicare Standardized Payment Amount | 1141.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 3998 |
| Number Of Medicare Beneficiaries With Medical Services | 776 |
| Total Medical Submitted Charge Amount | 614664.19 |
| Total Medical Medicare Allowed Amount | 323570.95 |
| Total Medical Medicare Payment Amount | 232229.44 |
| Total Medical Medicare Standardized Payment Amount | 250107.85 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 134 |
| Number Of Beneficiaries Age 65 to 74 | 279 |
| Number Of Beneficiaries Age 75 to 84 | 226 |
| Number Of Beneficiaries Age Greater 84 | 137 |
| Number Of Female Beneficiaries | 481 |
| Number Of Male Beneficiaries | 295 |
| Number Of Non Hispanic White Beneficiaries | 723 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 438 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 338 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 38 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 25 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4361 |