| National Provider Identifier [NPI]: | 1265498976 |
| Last Name Of The Provider | STAPLETON |
| First Name Of The Provider | RUSSELL |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 820 PRUDENTIAL DR |
| Street Address 2 Of The Provider | SUITE 112 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322078210 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 4498 |
| Number Of Medicare Beneficiaries | 1469 |
| Total Submitted Charge Amount | 861359.45 |
| Total Medicare Allowed Amount | 349548.93 |
| Total Medicare Payment Amount | 266648.16 |
| Total Medicare Standardized Payment Amount | 264731.42 |
| 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 | 60 |
| Number Of Medical Services | 4498 |
| Number Of Medicare Beneficiaries With Medical Services | 1469 |
| Total Medical Submitted Charge Amount | 861359.45 |
| Total Medical Medicare Allowed Amount | 349548.93 |
| Total Medical Medicare Payment Amount | 266648.16 |
| Total Medical Medicare Standardized Payment Amount | 264731.42 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 199 |
| Number Of Beneficiaries Age 65 to 74 | 596 |
| Number Of Beneficiaries Age 75 to 84 | 455 |
| Number Of Beneficiaries Age Greater 84 | 219 |
| Number Of Female Beneficiaries | 742 |
| Number Of Male Beneficiaries | 727 |
| Number Of Non Hispanic White Beneficiaries | 1165 |
| Number Of Black or African American Beneficiaries | 257 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1171 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 298 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.8845 |