| National Provider Identifier [NPI]: | 1104894286 |
| Last Name Of The Provider | HUTAIN |
| First Name Of The Provider | ROYCE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 501 N CORNELL AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FULLERTON |
| Zip Code Of The Provider | 928312744 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 1215 |
| Number Of Medicare Beneficiaries | 279 |
| Total Submitted Charge Amount | 60327.44 |
| Total Medicare Allowed Amount | 54722.95 |
| Total Medicare Payment Amount | 35406.77 |
| Total Medicare Standardized Payment Amount | 32225.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 496 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 2453 |
| Total Drug Medicare AllowedAmount | 1290.31 |
| Total Drug Medicare PaymentAmount | 1077.53 |
| Total Drug Medicare Standardized Payment Amount | 1077.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 24 |
| Number Of Medical Services | 719 |
| Number Of Medicare Beneficiaries With Medical Services | 278 |
| Total Medical Submitted Charge Amount | 57874.44 |
| Total Medical Medicare Allowed Amount | 53432.64 |
| Total Medical Medicare Payment Amount | 34329.24 |
| Total Medical Medicare Standardized Payment Amount | 31147.77 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 156 |
| Number Of Male Beneficiaries | 123 |
| Number Of Non Hispanic White Beneficiaries | 243 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 264 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 39 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 22 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.8632 |