| National Provider Identifier [NPI]: | 1609872118 |
| Last Name Of The Provider | GUTIERREZ |
| First Name Of The Provider | ALBERT |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12037 CORTEZ BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROOKSVILLE |
| Zip Code Of The Provider | 346137349 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 200 |
| Number Of Services | 7113 |
| Number Of Medicare Beneficiaries | 3410 |
| Total Submitted Charge Amount | 2823682.71 |
| Total Medicare Allowed Amount | 791137.12 |
| Total Medicare Payment Amount | 612461.37 |
| Total Medicare Standardized Payment Amount | 631986.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 67 |
| Number Of Medicare Beneficiaries With Drug Services | 65 |
| Total Drug Submitted ChargeAmount | 3077.36 |
| Total Drug Medicare AllowedAmount | 1368.75 |
| Total Drug Medicare PaymentAmount | 1072.96 |
| Total Drug Medicare Standardized Payment Amount | 1072.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 193 |
| Number Of Medical Services | 7046 |
| Number Of Medicare Beneficiaries With Medical Services | 3408 |
| Total Medical Submitted Charge Amount | 2820605.35 |
| Total Medical Medicare Allowed Amount | 789768.37 |
| Total Medical Medicare Payment Amount | 611388.41 |
| Total Medical Medicare Standardized Payment Amount | 630913.27 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 414 |
| Number Of Beneficiaries Age 65 to 74 | 1633 |
| Number Of Beneficiaries Age 75 to 84 | 998 |
| Number Of Beneficiaries Age Greater 84 | 365 |
| Number Of Female Beneficiaries | 2212 |
| Number Of Male Beneficiaries | 1198 |
| Number Of Non Hispanic White Beneficiaries | 3070 |
| Number Of Black or African American Beneficiaries | 120 |
| Number Of AsianPacific Islander Beneficiaries | 13 |
| Number Of Hispanic Beneficiaries | 161 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 46 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3078 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 332 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.3052 |