| National Provider Identifier [NPI]: | 1346398260 |
| Last Name Of The Provider | YUTANI |
| First Name Of The Provider | RAY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 795 E. SECOND ST. |
| Street Address 2 Of The Provider | SUITE 5 |
| City Of The Provider | POMONA |
| Zip Code Of The Provider | 917662007 |
| 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 | 16 |
| Number Of Services | 252 |
| Number Of Medicare Beneficiaries | 39 |
| Total Submitted Charge Amount | 20096 |
| Total Medicare Allowed Amount | 13262.24 |
| Total Medicare Payment Amount | 8805.21 |
| Total Medicare Standardized Payment Amount | 8175.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 16 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 518 |
| Total Drug Medicare AllowedAmount | 369.32 |
| Total Drug Medicare PaymentAmount | 359.51 |
| Total Drug Medicare Standardized Payment Amount | 359.51 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 12 |
| Number Of Medical Services | 236 |
| Number Of Medicare Beneficiaries With Medical Services | 39 |
| Total Medical Submitted Charge Amount | 19578 |
| Total Medical Medicare Allowed Amount | 12892.92 |
| Total Medical Medicare Payment Amount | 8445.7 |
| Total Medical Medicare Standardized Payment Amount | 7815.98 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 18 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 17 |
| Number Of Male Beneficiaries | 22 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | |
| Percent Of With Osteoporosis | 0 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 2.1515 |