| National Provider Identifier [NPI]: | 1447367982 |
| Last Name Of The Provider | KUTTICKAT |
| First Name Of The Provider | GEORGE |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2414 KOHLER MEMORIAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SHEBOYGAN |
| Zip Code Of The Provider | 53081 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 74 |
| Number Of Services | 7889 |
| Number Of Medicare Beneficiaries | 1299 |
| Total Submitted Charge Amount | 4089574.24 |
| Total Medicare Allowed Amount | 514444.39 |
| Total Medicare Payment Amount | 384810.93 |
| Total Medicare Standardized Payment Amount | 401292.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 691 |
| Number Of Medicare Beneficiaries With Drug Services | 162 |
| Total Drug Submitted ChargeAmount | 62715.24 |
| Total Drug Medicare AllowedAmount | 25789.95 |
| Total Drug Medicare PaymentAmount | 19779.46 |
| Total Drug Medicare Standardized Payment Amount | 19779.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 7198 |
| Number Of Medicare Beneficiaries With Medical Services | 1298 |
| Total Medical Submitted Charge Amount | 4026859 |
| Total Medical Medicare Allowed Amount | 488654.44 |
| Total Medical Medicare Payment Amount | 365031.47 |
| Total Medical Medicare Standardized Payment Amount | 381513.23 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 151 |
| Number Of Beneficiaries Age 65 to 74 | 509 |
| Number Of Beneficiaries Age 75 to 84 | 400 |
| Number Of Beneficiaries Age Greater 84 | 239 |
| Number Of Female Beneficiaries | 595 |
| Number Of Male Beneficiaries | 704 |
| Number Of Non Hispanic White Beneficiaries | 1221 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1103 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 196 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3601 |