| National Provider Identifier [NPI]: | 1447349972 |
| Last Name Of The Provider | RUTKOWSKI |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4400 ROCKSIDE RD |
| Street Address 2 Of The Provider | SUITE 2100 |
| City Of The Provider | INDEPENDENCE |
| Zip Code Of The Provider | 441312109 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 1290 |
| Number Of Medicare Beneficiaries | 223 |
| Total Submitted Charge Amount | 123245 |
| Total Medicare Allowed Amount | 77681.89 |
| Total Medicare Payment Amount | 52139.48 |
| Total Medicare Standardized Payment Amount | 56690.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 169 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 4615 |
| Total Drug Medicare AllowedAmount | 1173.88 |
| Total Drug Medicare PaymentAmount | 1053.33 |
| Total Drug Medicare Standardized Payment Amount | 1053.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 1121 |
| Number Of Medicare Beneficiaries With Medical Services | 223 |
| Total Medical Submitted Charge Amount | 118630 |
| Total Medical Medicare Allowed Amount | 76508.01 |
| Total Medical Medicare Payment Amount | 51086.15 |
| Total Medical Medicare Standardized Payment Amount | 55636.89 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 60 |
| Number Of Beneficiaries Age 65 to 74 | 100 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 13 |
| Number Of Female Beneficiaries | 135 |
| Number Of Male Beneficiaries | 88 |
| Number Of Non Hispanic White Beneficiaries | 203 |
| 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 | 164 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8417 |