| National Provider Identifier [NPI]: | 1003012154 |
| Last Name Of The Provider | REUTTER |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1068 W BALTIMORE PIKE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MEDIA |
| Zip Code Of The Provider | 190635104 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 1309 |
| Number Of Medicare Beneficiaries | 782 |
| Total Submitted Charge Amount | 532598 |
| Total Medicare Allowed Amount | 143849.8 |
| Total Medicare Payment Amount | 110493.56 |
| Total Medicare Standardized Payment Amount | 104869.12 |
| 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 | 29 |
| Number Of Medical Services | 1309 |
| Number Of Medicare Beneficiaries With Medical Services | 782 |
| Total Medical Submitted Charge Amount | 532598 |
| Total Medical Medicare Allowed Amount | 143849.8 |
| Total Medical Medicare Payment Amount | 110493.56 |
| Total Medical Medicare Standardized Payment Amount | 104869.12 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 110 |
| Number Of Beneficiaries Age 65 to 74 | 217 |
| Number Of Beneficiaries Age 75 to 84 | 215 |
| Number Of Beneficiaries Age Greater 84 | 240 |
| Number Of Female Beneficiaries | 471 |
| Number Of Male Beneficiaries | 311 |
| Number Of Non Hispanic White Beneficiaries | 709 |
| Number Of Black or African American Beneficiaries | 59 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 573 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 209 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 1.9737 |