| National Provider Identifier [NPI]: | 1033181219 |
| Last Name Of The Provider | RUSSO |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2605 KEISER BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WYOMISSING |
| Zip Code Of The Provider | 196103338 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 6670 |
| Number Of Medicare Beneficiaries | 2016 |
| Total Submitted Charge Amount | 1727417.09 |
| Total Medicare Allowed Amount | 776576.83 |
| Total Medicare Payment Amount | 587846.33 |
| Total Medicare Standardized Payment Amount | 609648.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1188 |
| Number Of Medicare Beneficiaries With Drug Services | 276 |
| Total Drug Submitted ChargeAmount | 58115.42 |
| Total Drug Medicare AllowedAmount | 57991.16 |
| Total Drug Medicare PaymentAmount | 45005.47 |
| Total Drug Medicare Standardized Payment Amount | 45005.47 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 5482 |
| Number Of Medicare Beneficiaries With Medical Services | 2016 |
| Total Medical Submitted Charge Amount | 1669301.67 |
| Total Medical Medicare Allowed Amount | 718585.67 |
| Total Medical Medicare Payment Amount | 542840.86 |
| Total Medical Medicare Standardized Payment Amount | 564642.77 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 232 |
| Number Of Beneficiaries Age 65 to 74 | 670 |
| Number Of Beneficiaries Age 75 to 84 | 760 |
| Number Of Beneficiaries Age Greater 84 | 354 |
| Number Of Female Beneficiaries | 994 |
| Number Of Male Beneficiaries | 1022 |
| Number Of Non Hispanic White Beneficiaries | 1828 |
| Number Of Black or African American Beneficiaries | 55 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 106 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1708 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 308 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5979 |