| National Provider Identifier [NPI]: | 1174578348 |
| Last Name Of The Provider | METZ |
| First Name Of The Provider | RUSSELL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 103 SOLANA ROAD SUITE B |
| Street Address 2 Of The Provider | |
| City Of The Provider | PONTE VEDRA BEACH |
| Zip Code Of The Provider | 32082 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 89 |
| Number Of Services | 10301 |
| Number Of Medicare Beneficiaries | 2064 |
| Total Submitted Charge Amount | 910663.55 |
| Total Medicare Allowed Amount | 629535.07 |
| Total Medicare Payment Amount | 452018.22 |
| Total Medicare Standardized Payment Amount | 450839.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 87 |
| Number Of Medicare Beneficiaries With Drug Services | 77 |
| Total Drug Submitted ChargeAmount | 25275 |
| Total Drug Medicare AllowedAmount | 18983.68 |
| Total Drug Medicare PaymentAmount | 14283.84 |
| Total Drug Medicare Standardized Payment Amount | 14283.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 10214 |
| Number Of Medicare Beneficiaries With Medical Services | 2062 |
| Total Medical Submitted Charge Amount | 885388.55 |
| Total Medical Medicare Allowed Amount | 610551.39 |
| Total Medical Medicare Payment Amount | 437734.38 |
| Total Medical Medicare Standardized Payment Amount | 436556.11 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 32 |
| Number Of Beneficiaries Age 65 to 74 | 1033 |
| Number Of Beneficiaries Age 75 to 84 | 736 |
| Number Of Beneficiaries Age Greater 84 | 263 |
| Number Of Female Beneficiaries | 1001 |
| Number Of Male Beneficiaries | 1063 |
| Number Of Non Hispanic White Beneficiaries | 2024 |
| 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 | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2045 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9201 |