| National Provider Identifier [NPI]: | 1568684868 |
| Last Name Of The Provider | VAKA |
| First Name Of The Provider | SUSMITHA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2 SHIRCLIFF WAY |
| Street Address 2 Of The Provider | SUITE 800 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322044753 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 5841 |
| Number Of Medicare Beneficiaries | 41 |
| Total Submitted Charge Amount | 339347.33 |
| Total Medicare Allowed Amount | 265805.55 |
| Total Medicare Payment Amount | 207087.1 |
| Total Medicare Standardized Payment Amount | 208951.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 21 |
| Number Of Drug Services | 5618 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 283859.69 |
| Total Drug Medicare AllowedAmount | 247586.62 |
| Total Drug Medicare PaymentAmount | 194074.09 |
| Total Drug Medicare Standardized Payment Amount | 194074.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 223 |
| Number Of Medicare Beneficiaries With Medical Services | 41 |
| Total Medical Submitted Charge Amount | 55487.64 |
| Total Medical Medicare Allowed Amount | 18218.93 |
| Total Medical Medicare Payment Amount | 13013.01 |
| Total Medical Medicare Standardized Payment Amount | 14877.2 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 21 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 30 |
| Number Of Male Beneficiaries | 11 |
| Number Of Non Hispanic White Beneficiaries | 30 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 34 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.9693 |