| National Provider Identifier [NPI]: | 1982608501 |
| Last Name Of The Provider | KING |
| First Name Of The Provider | RUSSELL |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1120 KANAWHA BLVD E |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARLESTON |
| Zip Code Of The Provider | 253012400 |
| State Code Of The Provider | WV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 205 |
| Number Of Services | 8051 |
| Number Of Medicare Beneficiaries | 5079 |
| Total Submitted Charge Amount | 997679 |
| Total Medicare Allowed Amount | 218129.01 |
| Total Medicare Payment Amount | 165070.88 |
| Total Medicare Standardized Payment Amount | 172963.45 |
| 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 | 205 |
| Number Of Medical Services | 8051 |
| Number Of Medicare Beneficiaries With Medical Services | 5079 |
| Total Medical Submitted Charge Amount | 997679 |
| Total Medical Medicare Allowed Amount | 218129.01 |
| Total Medical Medicare Payment Amount | 165070.88 |
| Total Medical Medicare Standardized Payment Amount | 172963.45 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 1384 |
| Number Of Beneficiaries Age 65 to 74 | 1847 |
| Number Of Beneficiaries Age 75 to 84 | 1292 |
| Number Of Beneficiaries Age Greater 84 | 556 |
| Number Of Female Beneficiaries | 2891 |
| Number Of Male Beneficiaries | 2188 |
| Number Of Non Hispanic White Beneficiaries | 4848 |
| Number Of Black or African American Beneficiaries | 174 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3363 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1716 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7531 |