| National Provider Identifier [NPI]: | 1003078254 |
| Last Name Of The Provider | RUTKOWSKI |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 575 N RIVER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WILKES BARRE |
| Zip Code Of The Provider | 187640999 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 2861 |
| Number Of Medicare Beneficiaries | 788 |
| Total Submitted Charge Amount | 471719.33 |
| Total Medicare Allowed Amount | 292833.97 |
| Total Medicare Payment Amount | 225222.94 |
| Total Medicare Standardized Payment Amount | 213740.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 2861 |
| Number Of Medicare Beneficiaries With Medical Services | 788 |
| Total Medical Submitted Charge Amount | 471719.33 |
| Total Medical Medicare Allowed Amount | 292833.97 |
| Total Medical Medicare Payment Amount | 225222.94 |
| Total Medical Medicare Standardized Payment Amount | 213740.78 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 158 |
| Number Of Beneficiaries Age 65 to 74 | 214 |
| Number Of Beneficiaries Age 75 to 84 | 210 |
| Number Of Beneficiaries Age Greater 84 | 206 |
| Number Of Female Beneficiaries | 461 |
| Number Of Male Beneficiaries | 327 |
| Number Of Non Hispanic White Beneficiaries | 748 |
| Number Of Black or African American Beneficiaries | 18 |
| 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 | 531 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 257 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.916 |