| National Provider Identifier [NPI]: | 1366493991 |
| Last Name Of The Provider | KUKLA |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 LANGWORTHY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DUBUQUE |
| Zip Code Of The Provider | 520017313 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 120 |
| Number Of Services | 12206 |
| Number Of Medicare Beneficiaries | 120 |
| Total Submitted Charge Amount | 374096.31 |
| Total Medicare Allowed Amount | 176989.82 |
| Total Medicare Payment Amount | 137359.17 |
| Total Medicare Standardized Payment Amount | 139794.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 38 |
| Number Of Drug Services | 10435 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 245655 |
| Total Drug Medicare AllowedAmount | 124845.8 |
| Total Drug Medicare PaymentAmount | 97723.64 |
| Total Drug Medicare Standardized Payment Amount | 97723.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 82 |
| Number Of Medical Services | 1771 |
| Number Of Medicare Beneficiaries With Medical Services | 120 |
| Total Medical Submitted Charge Amount | 128441.31 |
| Total Medical Medicare Allowed Amount | 52144.02 |
| Total Medical Medicare Payment Amount | 39635.53 |
| Total Medical Medicare Standardized Payment Amount | 42070.62 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 57 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 86 |
| Number Of Male Beneficiaries | 34 |
| 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 | 108 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 68 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 19 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.599 |