| National Provider Identifier [NPI]: | 1316028376 |
| Last Name Of The Provider | RUSSO |
| First Name Of The Provider | JACQUELINE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5427 SW 75TH TER |
| Street Address 2 Of The Provider | |
| City Of The Provider | GAINESVILLE |
| Zip Code Of The Provider | 326084413 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 18902 |
| Number Of Medicare Beneficiaries | 7443 |
| Total Submitted Charge Amount | 3008650 |
| Total Medicare Allowed Amount | 870384.17 |
| Total Medicare Payment Amount | 670643.66 |
| Total Medicare Standardized Payment Amount | 465189.11 |
| 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 | 23 |
| Number Of Medical Services | 18902 |
| Number Of Medicare Beneficiaries With Medical Services | 7443 |
| Total Medical Submitted Charge Amount | 3008650 |
| Total Medical Medicare Allowed Amount | 870384.17 |
| Total Medical Medicare Payment Amount | 670643.66 |
| Total Medical Medicare Standardized Payment Amount | 465189.11 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 173 |
| Number Of Beneficiaries Age 65 to 74 | 3452 |
| Number Of Beneficiaries Age 75 to 84 | 2840 |
| Number Of Beneficiaries Age Greater 84 | 978 |
| Number Of Female Beneficiaries | 3578 |
| Number Of Male Beneficiaries | 3865 |
| Number Of Non Hispanic White Beneficiaries | 7220 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 89 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 82 |
| Number Of Beneficiaries With Medicare Only Entitlement | 7164 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 279 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9948 |