| National Provider Identifier [NPI]: | 1700801453 |
| Last Name Of The Provider | REESE |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1024 LEMAY AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT COLLINS |
| Zip Code Of The Provider | 80524 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 147 |
| Number Of Services | 6245 |
| Number Of Medicare Beneficiaries | 4537 |
| Total Submitted Charge Amount | 783916 |
| Total Medicare Allowed Amount | 206292.35 |
| Total Medicare Payment Amount | 147922.67 |
| Total Medicare Standardized Payment Amount | 150654.87 |
| 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 | 147 |
| Number Of Medical Services | 6245 |
| Number Of Medicare Beneficiaries With Medical Services | 4537 |
| Total Medical Submitted Charge Amount | 783916 |
| Total Medical Medicare Allowed Amount | 206292.35 |
| Total Medical Medicare Payment Amount | 147922.67 |
| Total Medical Medicare Standardized Payment Amount | 150654.87 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 755 |
| Number Of Beneficiaries Age 65 to 74 | 1655 |
| Number Of Beneficiaries Age 75 to 84 | 1323 |
| Number Of Beneficiaries Age Greater 84 | 804 |
| Number Of Female Beneficiaries | 2682 |
| Number Of Male Beneficiaries | 1855 |
| Number Of Non Hispanic White Beneficiaries | 4042 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | 377 |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | 60 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3540 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 997 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3771 |