| National Provider Identifier [NPI]: | 1144497322 |
| Last Name Of The Provider | NUTTALL |
| First Name Of The Provider | MARC |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1055 N 500 W |
| Street Address 2 Of The Provider | #202 |
| City Of The Provider | PROVO |
| Zip Code Of The Provider | 846043305 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 156 |
| Number Of Services | 124712 |
| Number Of Medicare Beneficiaries | 558 |
| Total Submitted Charge Amount | 2630726.01 |
| Total Medicare Allowed Amount | 1418034.72 |
| Total Medicare Payment Amount | 1101582.84 |
| Total Medicare Standardized Payment Amount | 1111350.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 70 |
| Number Of Drug Services | 111552 |
| Number Of Medicare Beneficiaries With Drug Services | 271 |
| Total Drug Submitted ChargeAmount | 2175061.01 |
| Total Drug Medicare AllowedAmount | 1198647.57 |
| Total Drug Medicare PaymentAmount | 931350.76 |
| Total Drug Medicare Standardized Payment Amount | 931350.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 86 |
| Number Of Medical Services | 13160 |
| Number Of Medicare Beneficiaries With Medical Services | 558 |
| Total Medical Submitted Charge Amount | 455665 |
| Total Medical Medicare Allowed Amount | 219387.15 |
| Total Medical Medicare Payment Amount | 170232.08 |
| Total Medical Medicare Standardized Payment Amount | 179999.3 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 67 |
| Number Of Beneficiaries Age 65 to 74 | 228 |
| Number Of Beneficiaries Age 75 to 84 | 206 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 332 |
| Number Of Male Beneficiaries | 226 |
| Number Of Non Hispanic White Beneficiaries | 529 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 506 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 36 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.9038 |