| National Provider Identifier [NPI]: | 1194887125 |
| Last Name Of The Provider | RUSSO |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1111 MEDICAL CENTER BLVD |
| Street Address 2 Of The Provider | SUITE S-555 |
| City Of The Provider | MARRERO |
| Zip Code Of The Provider | 700723151 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 64 |
| Number Of Services | 5509 |
| Number Of Medicare Beneficiaries | 434 |
| Total Submitted Charge Amount | 657890.5 |
| Total Medicare Allowed Amount | 427592.7 |
| Total Medicare Payment Amount | 325137.98 |
| Total Medicare Standardized Payment Amount | 326723.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 424 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 3876 |
| Total Drug Medicare AllowedAmount | 854.05 |
| Total Drug Medicare PaymentAmount | 788.87 |
| Total Drug Medicare Standardized Payment Amount | 788.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 5085 |
| Number Of Medicare Beneficiaries With Medical Services | 434 |
| Total Medical Submitted Charge Amount | 654014.5 |
| Total Medical Medicare Allowed Amount | 426738.65 |
| Total Medical Medicare Payment Amount | 324349.11 |
| Total Medical Medicare Standardized Payment Amount | 325935.07 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 181 |
| Number Of Beneficiaries Age 65 to 74 | 144 |
| Number Of Beneficiaries Age 75 to 84 | 72 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 225 |
| Number Of Male Beneficiaries | 209 |
| Number Of Non Hispanic White Beneficiaries | 162 |
| Number Of Black or African American Beneficiaries | 239 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 91 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 343 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 36 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 61 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 21 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 3.0861 |