| National Provider Identifier [NPI]: | 1114900693 |
| Last Name Of The Provider | HUETTNER |
| First Name Of The Provider | GLENN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4101 TORRANCE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TORRANCE |
| Zip Code Of The Provider | 905034607 |
| 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 | 199 |
| Number Of Services | 7304 |
| Number Of Medicare Beneficiaries | 2835 |
| Total Submitted Charge Amount | 1140447.29 |
| Total Medicare Allowed Amount | 212199.55 |
| Total Medicare Payment Amount | 162423.16 |
| Total Medicare Standardized Payment Amount | 153224.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2060 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 775.18 |
| Total Drug Medicare AllowedAmount | 430.06 |
| Total Drug Medicare PaymentAmount | 337.16 |
| Total Drug Medicare Standardized Payment Amount | 337.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 197 |
| Number Of Medical Services | 5244 |
| Number Of Medicare Beneficiaries With Medical Services | 2835 |
| Total Medical Submitted Charge Amount | 1139672.11 |
| Total Medical Medicare Allowed Amount | 211769.49 |
| Total Medical Medicare Payment Amount | 162086 |
| Total Medical Medicare Standardized Payment Amount | 152886.87 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 331 |
| Number Of Beneficiaries Age 65 to 74 | 1049 |
| Number Of Beneficiaries Age 75 to 84 | 855 |
| Number Of Beneficiaries Age Greater 84 | 600 |
| Number Of Female Beneficiaries | 2008 |
| Number Of Male Beneficiaries | 827 |
| Number Of Non Hispanic White Beneficiaries | 1480 |
| Number Of Black or African American Beneficiaries | 337 |
| Number Of AsianPacific Islander Beneficiaries | 507 |
| Number Of Hispanic Beneficiaries | 422 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1897 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 938 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7919 |