| National Provider Identifier [NPI]: | 1063486660 |
| Last Name Of The Provider | RUSSELL |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2700 CLAY EDWARDS DR |
| Street Address 2 Of The Provider | SUITE 360 |
| City Of The Provider | KANSAS CITY |
| Zip Code Of The Provider | 641163251 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 1199 |
| Number Of Medicare Beneficiaries | 305 |
| Total Submitted Charge Amount | 145945 |
| Total Medicare Allowed Amount | 120505.12 |
| Total Medicare Payment Amount | 84782.92 |
| Total Medicare Standardized Payment Amount | 88703.15 |
| 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 | 17 |
| Number Of Medical Services | 1199 |
| Number Of Medicare Beneficiaries With Medical Services | 305 |
| Total Medical Submitted Charge Amount | 145945 |
| Total Medical Medicare Allowed Amount | 120505.12 |
| Total Medical Medicare Payment Amount | 84782.92 |
| Total Medical Medicare Standardized Payment Amount | 88703.15 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 141 |
| Number Of Beneficiaries Age 75 to 84 | 82 |
| Number Of Beneficiaries Age Greater 84 | 44 |
| Number Of Female Beneficiaries | 157 |
| Number Of Male Beneficiaries | 148 |
| Number Of Non Hispanic White Beneficiaries | 280 |
| Number Of Black or African American Beneficiaries | 12 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 283 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0791 |