| National Provider Identifier [NPI]: | 1922399849 |
| Last Name Of The Provider | RUSSELL |
| First Name Of The Provider | ALEXANDRA |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DPT |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 225 PHYSICIANS PARK |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | POPLAR BLUFF |
| Zip Code Of The Provider | 639013956 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Therapist |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 10719 |
| Number Of Medicare Beneficiaries | 287 |
| Total Submitted Charge Amount | 522874.78 |
| Total Medicare Allowed Amount | 254125.75 |
| Total Medicare Payment Amount | 191333.76 |
| Total Medicare Standardized Payment Amount | 145374.68 |
| 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 | 21 |
| Number Of Medical Services | 10719 |
| Number Of Medicare Beneficiaries With Medical Services | 287 |
| Total Medical Submitted Charge Amount | 522874.78 |
| Total Medical Medicare Allowed Amount | 254125.75 |
| Total Medical Medicare Payment Amount | 191333.76 |
| Total Medical Medicare Standardized Payment Amount | 145374.68 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 94 |
| Number Of Beneficiaries Age 65 to 74 | 138 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 184 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | 268 |
| Number Of Black or African American Beneficiaries | |
| 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 | 197 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 90 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 72 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0215 |