| National Provider Identifier [NPI]: | 1255547717 |
| Last Name Of The Provider | DUTKA |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2501 KUSER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | HAMILTON |
| Zip Code Of The Provider | 086913386 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 189 |
| Number Of Services | 6061 |
| Number Of Medicare Beneficiaries | 3299 |
| Total Submitted Charge Amount | 773900 |
| Total Medicare Allowed Amount | 212566.27 |
| Total Medicare Payment Amount | 158169.94 |
| Total Medicare Standardized Payment Amount | 151765.51 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 716 |
| Number Of Beneficiaries Age 65 to 74 | 1214 |
| Number Of Beneficiaries Age 75 to 84 | 813 |
| Number Of Beneficiaries Age Greater 84 | 556 |
| Number Of Female Beneficiaries | 1963 |
| Number Of Male Beneficiaries | 1336 |
| Number Of Non Hispanic White Beneficiaries | 2467 |
| Number Of Black or African American Beneficiaries | 598 |
| Number Of AsianPacific Islander Beneficiaries | 63 |
| Number Of Hispanic Beneficiaries | 122 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 49 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2270 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1029 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.7265 |