| National Provider Identifier [NPI]: | 1649210659 |
| Last Name Of The Provider | GUTTUSO |
| First Name Of The Provider | PAUL |
| 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 | 604 S 3RD ST STE A |
| Street Address 2 Of The Provider | |
| City Of The Provider | MABANK |
| Zip Code Of The Provider | 751472727 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 4029 |
| Number Of Medicare Beneficiaries | 384 |
| Total Submitted Charge Amount | 401527 |
| Total Medicare Allowed Amount | 180266.16 |
| Total Medicare Payment Amount | 126760.11 |
| Total Medicare Standardized Payment Amount | 135038.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 496 |
| Number Of Medicare Beneficiaries With Drug Services | 212 |
| Total Drug Submitted ChargeAmount | 20388 |
| Total Drug Medicare AllowedAmount | 7303.87 |
| Total Drug Medicare PaymentAmount | 6572.37 |
| Total Drug Medicare Standardized Payment Amount | 6572.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 93 |
| Number Of Medical Services | 3533 |
| Number Of Medicare Beneficiaries With Medical Services | 384 |
| Total Medical Submitted Charge Amount | 381139 |
| Total Medical Medicare Allowed Amount | 172962.29 |
| Total Medical Medicare Payment Amount | 120187.74 |
| Total Medical Medicare Standardized Payment Amount | 128466.54 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 197 |
| Number Of Beneficiaries Age 75 to 84 | 94 |
| Number Of Beneficiaries Age Greater 84 | 48 |
| Number Of Female Beneficiaries | 237 |
| Number Of Male Beneficiaries | 147 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 328 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.14 |