| National Provider Identifier [NPI]: | 1518212513 |
| Last Name Of The Provider | RUSSELL |
| First Name Of The Provider | AMANDA |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | PA-C |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13700 ST FRANCIS BLVD |
| Street Address 2 Of The Provider | # 103 |
| City Of The Provider | MIDLOTHIAN |
| Zip Code Of The Provider | 231143222 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 1109 |
| Number Of Medicare Beneficiaries | 277 |
| Total Submitted Charge Amount | 236484 |
| Total Medicare Allowed Amount | 61555.67 |
| Total Medicare Payment Amount | 47496.99 |
| Total Medicare Standardized Payment Amount | 51630.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 341 |
| Number Of Medicare Beneficiaries With Drug Services | 73 |
| Total Drug Submitted ChargeAmount | 10838 |
| Total Drug Medicare AllowedAmount | 9045.08 |
| Total Drug Medicare PaymentAmount | 7045.02 |
| Total Drug Medicare Standardized Payment Amount | 7045.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 768 |
| Number Of Medicare Beneficiaries With Medical Services | 277 |
| Total Medical Submitted Charge Amount | 225646 |
| Total Medical Medicare Allowed Amount | 52510.59 |
| Total Medical Medicare Payment Amount | 40451.97 |
| Total Medical Medicare Standardized Payment Amount | 44585.16 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 154 |
| Number Of Beneficiaries Age 75 to 84 | 79 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 152 |
| Number Of Male Beneficiaries | 125 |
| Number Of Non Hispanic White Beneficiaries | 245 |
| 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 | 264 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8808 |