| National Provider Identifier [NPI]: | 1316041064 |
| Last Name Of The Provider | CULTRERA |
| First Name Of The Provider | JENNIFER |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1400 N US HIGHWAY 441 |
| Street Address 2 Of The Provider | SUITE 552 |
| City Of The Provider | LADY LAKE |
| Zip Code Of The Provider | 321598975 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 210 |
| Number Of Services | 301680 |
| Number Of Medicare Beneficiaries | 1381 |
| Total Submitted Charge Amount | 9194523 |
| Total Medicare Allowed Amount | 3545834.11 |
| Total Medicare Payment Amount | 2791797.71 |
| Total Medicare Standardized Payment Amount | 2780067.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 106 |
| Number Of Drug Services | 264488 |
| Number Of Medicare Beneficiaries With Drug Services | 674 |
| Total Drug Submitted ChargeAmount | 7170334 |
| Total Drug Medicare AllowedAmount | 2794618.52 |
| Total Drug Medicare PaymentAmount | 2186325.59 |
| Total Drug Medicare Standardized Payment Amount | 2186325.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 104 |
| Number Of Medical Services | 37192 |
| Number Of Medicare Beneficiaries With Medical Services | 1381 |
| Total Medical Submitted Charge Amount | 2024189 |
| Total Medical Medicare Allowed Amount | 751215.59 |
| Total Medical Medicare Payment Amount | 605472.12 |
| Total Medical Medicare Standardized Payment Amount | 593742.19 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 106 |
| Number Of Beneficiaries Age 65 to 74 | 629 |
| Number Of Beneficiaries Age 75 to 84 | 502 |
| Number Of Beneficiaries Age Greater 84 | 144 |
| Number Of Female Beneficiaries | 768 |
| Number Of Male Beneficiaries | 613 |
| Number Of Non Hispanic White Beneficiaries | 1300 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 33 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1231 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 150 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 42 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.0925 |