| National Provider Identifier [NPI]: | 1619079670 |
| Last Name Of The Provider | KALRA |
| First Name Of The Provider | JYOTI |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1163 W STEPHENSON ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FREEPORT |
| Zip Code Of The Provider | 610324866 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Radiation Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 3980 |
| Number Of Medicare Beneficiaries | 171 |
| Total Submitted Charge Amount | 3606481.85 |
| Total Medicare Allowed Amount | 613295.68 |
| Total Medicare Payment Amount | 480029.46 |
| Total Medicare Standardized Payment Amount | 513459.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 25 |
| Number Of Drug Services | 1050 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 77537.02 |
| Total Drug Medicare AllowedAmount | 19844.17 |
| Total Drug Medicare PaymentAmount | 15557.86 |
| Total Drug Medicare Standardized Payment Amount | 15557.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 2930 |
| Number Of Medicare Beneficiaries With Medical Services | 171 |
| Total Medical Submitted Charge Amount | 3528944.83 |
| Total Medical Medicare Allowed Amount | 593451.51 |
| Total Medical Medicare Payment Amount | 464471.6 |
| Total Medical Medicare Standardized Payment Amount | 497901.45 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 67 |
| Number Of Beneficiaries Age 75 to 84 | 68 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 80 |
| Number Of Male Beneficiaries | 91 |
| Number Of Non Hispanic White Beneficiaries | 159 |
| 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 | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | 137 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 66 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3492 |