| National Provider Identifier [NPI]: | 1124082813 |
| Last Name Of The Provider | MAZDA |
| First Name Of The Provider | RUSSELL |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 140 NUTT RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHOENIXVILLE |
| Zip Code Of The Provider | 194603906 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 1217 |
| Number Of Medicare Beneficiaries | 777 |
| Total Submitted Charge Amount | 391244 |
| Total Medicare Allowed Amount | 130363.82 |
| Total Medicare Payment Amount | 99560.87 |
| Total Medicare Standardized Payment Amount | 94441.74 |
| 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 | 31 |
| Number Of Medical Services | 1217 |
| Number Of Medicare Beneficiaries With Medical Services | 777 |
| Total Medical Submitted Charge Amount | 391244 |
| Total Medical Medicare Allowed Amount | 130363.82 |
| Total Medical Medicare Payment Amount | 99560.87 |
| Total Medical Medicare Standardized Payment Amount | 94441.74 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 166 |
| Number Of Beneficiaries Age 65 to 74 | 233 |
| Number Of Beneficiaries Age 75 to 84 | 223 |
| Number Of Beneficiaries Age Greater 84 | 155 |
| Number Of Female Beneficiaries | 458 |
| Number Of Male Beneficiaries | 319 |
| Number Of Non Hispanic White Beneficiaries | 703 |
| Number Of Black or African American Beneficiaries | 45 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 539 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 238 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.8586 |