| National Provider Identifier [NPI]: | 1154319135 |
| Last Name Of The Provider | OWENS |
| First Name Of The Provider | RUSSELL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 423 N 21ST ST |
| Street Address 2 Of The Provider | STE 300 |
| City Of The Provider | CAMP HILL |
| Zip Code Of The Provider | 170112207 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 4154 |
| Number Of Medicare Beneficiaries | 1016 |
| Total Submitted Charge Amount | 716319 |
| Total Medicare Allowed Amount | 287153.78 |
| Total Medicare Payment Amount | 208975.4 |
| Total Medicare Standardized Payment Amount | 220601.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 515 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 218117 |
| Total Drug Medicare AllowedAmount | 63207.8 |
| Total Drug Medicare PaymentAmount | 45624 |
| Total Drug Medicare Standardized Payment Amount | 45624 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 80 |
| Number Of Medical Services | 3639 |
| Number Of Medicare Beneficiaries With Medical Services | 1016 |
| Total Medical Submitted Charge Amount | 498202 |
| Total Medical Medicare Allowed Amount | 223945.98 |
| Total Medical Medicare Payment Amount | 163351.4 |
| Total Medical Medicare Standardized Payment Amount | 174977.03 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 456 |
| Number Of Beneficiaries Age 75 to 84 | 360 |
| Number Of Beneficiaries Age Greater 84 | 147 |
| Number Of Female Beneficiaries | 236 |
| Number Of Male Beneficiaries | 780 |
| Number Of Non Hispanic White Beneficiaries | 956 |
| Number Of Black or African American Beneficiaries | 34 |
| 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 | 970 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 29 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1751 |