| National Provider Identifier [NPI]: | 1457435752 |
| Last Name Of The Provider | RUST |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3690 SAINT JOHNS BLUFF RD S |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322242616 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 587 |
| Number Of Medicare Beneficiaries | 114 |
| Total Submitted Charge Amount | 88683 |
| Total Medicare Allowed Amount | 52988.97 |
| Total Medicare Payment Amount | 36597.03 |
| Total Medicare Standardized Payment Amount | 37372.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 41 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 1540 |
| Total Drug Medicare AllowedAmount | 1205.16 |
| Total Drug Medicare PaymentAmount | 1180.32 |
| Total Drug Medicare Standardized Payment Amount | 1180.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 546 |
| Number Of Medicare Beneficiaries With Medical Services | 114 |
| Total Medical Submitted Charge Amount | 87143 |
| Total Medical Medicare Allowed Amount | 51783.81 |
| Total Medical Medicare Payment Amount | 35416.71 |
| Total Medical Medicare Standardized Payment Amount | 36192.42 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | 26 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 57 |
| Number Of Male Beneficiaries | 57 |
| Number Of Non Hispanic White Beneficiaries | 99 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7216 |