| National Provider Identifier [NPI]: | 1396749263 |
| Last Name Of The Provider | DUTTON |
| First Name Of The Provider | NEWELL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12554 RIATA VISTA CIR |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUSTIN |
| Zip Code Of The Provider | 787276431 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 255 |
| Number Of Services | 5483 |
| Number Of Medicare Beneficiaries | 2454 |
| Total Submitted Charge Amount | 698156.9 |
| Total Medicare Allowed Amount | 147840.26 |
| Total Medicare Payment Amount | 113402.02 |
| Total Medicare Standardized Payment Amount | 117864.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1691 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 1339.4 |
| Total Drug Medicare AllowedAmount | 312.18 |
| Total Drug Medicare PaymentAmount | 240.56 |
| Total Drug Medicare Standardized Payment Amount | 240.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 253 |
| Number Of Medical Services | 3792 |
| Number Of Medicare Beneficiaries With Medical Services | 2454 |
| Total Medical Submitted Charge Amount | 696817.5 |
| Total Medical Medicare Allowed Amount | 147528.08 |
| Total Medical Medicare Payment Amount | 113161.46 |
| Total Medical Medicare Standardized Payment Amount | 117624.36 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 444 |
| Number Of Beneficiaries Age 65 to 74 | 900 |
| Number Of Beneficiaries Age 75 to 84 | 700 |
| Number Of Beneficiaries Age Greater 84 | 410 |
| Number Of Female Beneficiaries | 1459 |
| Number Of Male Beneficiaries | 995 |
| Number Of Non Hispanic White Beneficiaries | 1806 |
| Number Of Black or African American Beneficiaries | 251 |
| Number Of AsianPacific Islander Beneficiaries | 59 |
| Number Of Hispanic Beneficiaries | 317 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1876 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 578 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.1425 |