| National Provider Identifier [NPI]: | 1063513224 |
| Last Name Of The Provider | KAMBAL |
| First Name Of The Provider | KHALID |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.B,B.CH |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1095 HIGHWAY 15 S |
| Street Address 2 Of The Provider | CANCER CENTER |
| City Of The Provider | HUTCHINSON |
| Zip Code Of The Provider | 553505000 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 291 |
| Number Of Medicare Beneficiaries | 115 |
| Total Submitted Charge Amount | 97795 |
| Total Medicare Allowed Amount | 27338.7 |
| Total Medicare Payment Amount | 19991.83 |
| Total Medicare Standardized Payment Amount | 20592.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 7 |
| Number Of Medical Services | 291 |
| Number Of Medicare Beneficiaries With Medical Services | 115 |
| Total Medical Submitted Charge Amount | 97795 |
| Total Medical Medicare Allowed Amount | 27338.7 |
| Total Medical Medicare Payment Amount | 19991.83 |
| Total Medical Medicare Standardized Payment Amount | 20592.87 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 16 |
| Number Of Beneficiaries Age 65 to 74 | 28 |
| Number Of Beneficiaries Age 75 to 84 | 45 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 71 |
| Number Of Male Beneficiaries | 44 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 102 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 51 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 24 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.9382 |