| National Provider Identifier [NPI]: | 1619948098 |
| Last Name Of The Provider | BANDSTRA |
| First Name Of The Provider | RUSSELL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 122 4TH AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRINNELL |
| Zip Code Of The Provider | 501121829 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 2765 |
| Number Of Medicare Beneficiaries | 777 |
| Total Submitted Charge Amount | 1000470 |
| Total Medicare Allowed Amount | 262819.77 |
| Total Medicare Payment Amount | 196913.19 |
| Total Medicare Standardized Payment Amount | 210901.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 262 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 65360 |
| Total Drug Medicare AllowedAmount | 44636.87 |
| Total Drug Medicare PaymentAmount | 34637.59 |
| Total Drug Medicare Standardized Payment Amount | 34637.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 2503 |
| Number Of Medicare Beneficiaries With Medical Services | 777 |
| Total Medical Submitted Charge Amount | 935110 |
| Total Medical Medicare Allowed Amount | 218182.9 |
| Total Medical Medicare Payment Amount | 162275.6 |
| Total Medical Medicare Standardized Payment Amount | 176264.29 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 288 |
| Number Of Beneficiaries Age 75 to 84 | 306 |
| Number Of Beneficiaries Age Greater 84 | 140 |
| Number Of Female Beneficiaries | 139 |
| Number Of Male Beneficiaries | 638 |
| Number Of Non Hispanic White Beneficiaries | 759 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 709 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 2 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0132 |