| National Provider Identifier [NPI]: | 1427099001 |
| Last Name Of The Provider | MULLALLY |
| First Name Of The Provider | SEAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 15 STRAW AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORTHAMPTON |
| Zip Code Of The Provider | 010621491 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 34058 |
| Number Of Medicare Beneficiaries | 306 |
| Total Submitted Charge Amount | 1587227.77 |
| Total Medicare Allowed Amount | 1130188.01 |
| Total Medicare Payment Amount | 880366.01 |
| Total Medicare Standardized Payment Amount | 874731.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 50 |
| Number Of Drug Services | 31949 |
| Number Of Medicare Beneficiaries With Drug Services | 91 |
| Total Drug Submitted ChargeAmount | 1299404.77 |
| Total Drug Medicare AllowedAmount | 983295.41 |
| Total Drug Medicare PaymentAmount | 769892.04 |
| Total Drug Medicare Standardized Payment Amount | 769892.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 38 |
| Number Of Medical Services | 2109 |
| Number Of Medicare Beneficiaries With Medical Services | 306 |
| Total Medical Submitted Charge Amount | 287823 |
| Total Medical Medicare Allowed Amount | 146892.6 |
| Total Medical Medicare Payment Amount | 110473.97 |
| Total Medical Medicare Standardized Payment Amount | 104839.62 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 126 |
| Number Of Beneficiaries Age 75 to 84 | 82 |
| Number Of Beneficiaries Age Greater 84 | 55 |
| Number Of Female Beneficiaries | 142 |
| Number Of Male Beneficiaries | 164 |
| Number Of Non Hispanic White Beneficiaries | 295 |
| Number Of Black or African American Beneficiaries | |
| 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 | 248 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 37 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.9071 |