| National Provider Identifier [NPI]: | 1881610038 |
| Last Name Of The Provider | DUTTA |
| First Name Of The Provider | SANJIT |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 910 W 5TH AVE |
| Street Address 2 Of The Provider | 701 |
| City Of The Provider | SPOKANE |
| Zip Code Of The Provider | 992042966 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 108 |
| Number Of Services | 5358 |
| Number Of Medicare Beneficiaries | 655 |
| Total Submitted Charge Amount | 503617.36 |
| Total Medicare Allowed Amount | 225543 |
| Total Medicare Payment Amount | 167389.83 |
| Total Medicare Standardized Payment Amount | 169995.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 435 |
| Number Of Medicare Beneficiaries With Drug Services | 197 |
| Total Drug Submitted ChargeAmount | 9482 |
| Total Drug Medicare AllowedAmount | 6455.25 |
| Total Drug Medicare PaymentAmount | 6088.77 |
| Total Drug Medicare Standardized Payment Amount | 6088.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 100 |
| Number Of Medical Services | 4923 |
| Number Of Medicare Beneficiaries With Medical Services | 655 |
| Total Medical Submitted Charge Amount | 494135.36 |
| Total Medical Medicare Allowed Amount | 219087.75 |
| Total Medical Medicare Payment Amount | 161301.06 |
| Total Medical Medicare Standardized Payment Amount | 163907.12 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 98 |
| Number Of Beneficiaries Age 65 to 74 | 191 |
| Number Of Beneficiaries Age 75 to 84 | 206 |
| Number Of Beneficiaries Age Greater 84 | 160 |
| Number Of Female Beneficiaries | 404 |
| Number Of Male Beneficiaries | 251 |
| Number Of Non Hispanic White Beneficiaries | 606 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 532 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 123 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3778 |