| National Provider Identifier [NPI]: | 1790720019 |
| Last Name Of The Provider | MUKUNO |
| First Name Of The Provider | DWIGHT |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6305 COYLE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CARMICHAEL |
| Zip Code Of The Provider | 956080438 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 157 |
| Number Of Services | 23760 |
| Number Of Medicare Beneficiaries | 2713 |
| Total Submitted Charge Amount | 1616056.5 |
| Total Medicare Allowed Amount | 278810.87 |
| Total Medicare Payment Amount | 214826.68 |
| Total Medicare Standardized Payment Amount | 210443.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 20112 |
| Number Of Medicare Beneficiaries With Drug Services | 213 |
| Total Drug Submitted ChargeAmount | 41418.7 |
| Total Drug Medicare AllowedAmount | 5646.67 |
| Total Drug Medicare PaymentAmount | 4382.81 |
| Total Drug Medicare Standardized Payment Amount | 4382.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 152 |
| Number Of Medical Services | 3648 |
| Number Of Medicare Beneficiaries With Medical Services | 2712 |
| Total Medical Submitted Charge Amount | 1574637.8 |
| Total Medical Medicare Allowed Amount | 273164.2 |
| Total Medical Medicare Payment Amount | 210443.87 |
| Total Medical Medicare Standardized Payment Amount | 206060.47 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 545 |
| Number Of Beneficiaries Age 65 to 74 | 971 |
| Number Of Beneficiaries Age 75 to 84 | 716 |
| Number Of Beneficiaries Age Greater 84 | 481 |
| Number Of Female Beneficiaries | 1567 |
| Number Of Male Beneficiaries | 1146 |
| Number Of Non Hispanic White Beneficiaries | 1923 |
| Number Of Black or African American Beneficiaries | 227 |
| Number Of AsianPacific Islander Beneficiaries | 232 |
| Number Of Hispanic Beneficiaries | 251 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 65 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1619 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1094 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.8477 |