| National Provider Identifier [NPI]: | 1710969472 |
| Last Name Of The Provider | RUSSELL |
| First Name Of The Provider | RON |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1314 19TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MERIDIAN |
| Zip Code Of The Provider | 393014116 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 2588 |
| Number Of Medicare Beneficiaries | 913 |
| Total Submitted Charge Amount | 251893 |
| Total Medicare Allowed Amount | 151468.29 |
| Total Medicare Payment Amount | 116254.01 |
| Total Medicare Standardized Payment Amount | 123783.75 |
| 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 | 27 |
| Number Of Medical Services | 2588 |
| Number Of Medicare Beneficiaries With Medical Services | 913 |
| Total Medical Submitted Charge Amount | 251893 |
| Total Medical Medicare Allowed Amount | 151468.29 |
| Total Medical Medicare Payment Amount | 116254.01 |
| Total Medical Medicare Standardized Payment Amount | 123783.75 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 220 |
| Number Of Beneficiaries Age 65 to 74 | 315 |
| Number Of Beneficiaries Age 75 to 84 | 257 |
| Number Of Beneficiaries Age Greater 84 | 121 |
| Number Of Female Beneficiaries | 524 |
| Number Of Male Beneficiaries | 389 |
| Number Of Non Hispanic White Beneficiaries | 578 |
| Number Of Black or African American Beneficiaries | 322 |
| 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 | 502 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 411 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.6726 |