| National Provider Identifier [NPI]: | 1578568366 |
| Last Name Of The Provider | DUTTER |
| First Name Of The Provider | DARYL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 VERA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | RIPON |
| Zip Code Of The Provider | 953662343 |
| 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 | 59 |
| Number Of Services | 3497 |
| Number Of Medicare Beneficiaries | 523 |
| Total Submitted Charge Amount | 159946.41 |
| Total Medicare Allowed Amount | 129070.13 |
| Total Medicare Payment Amount | 86087.54 |
| Total Medicare Standardized Payment Amount | 83899.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 736 |
| Number Of Medicare Beneficiaries With Drug Services | 121 |
| Total Drug Submitted ChargeAmount | 14061.41 |
| Total Drug Medicare AllowedAmount | 10207.92 |
| Total Drug Medicare PaymentAmount | 8395.06 |
| Total Drug Medicare Standardized Payment Amount | 8395.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 2761 |
| Number Of Medicare Beneficiaries With Medical Services | 522 |
| Total Medical Submitted Charge Amount | 145885 |
| Total Medical Medicare Allowed Amount | 118862.21 |
| Total Medical Medicare Payment Amount | 77692.48 |
| Total Medical Medicare Standardized Payment Amount | 75504.57 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 50 |
| Number Of Beneficiaries Age 65 to 74 | 199 |
| Number Of Beneficiaries Age 75 to 84 | 119 |
| Number Of Beneficiaries Age Greater 84 | 155 |
| Number Of Female Beneficiaries | 315 |
| Number Of Male Beneficiaries | 208 |
| Number Of Non Hispanic White Beneficiaries | 460 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 437 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0146 |