| National Provider Identifier [NPI]: | 1750311536 |
| Last Name Of The Provider | MONEYPENNY |
| First Name Of The Provider | RUSSELL |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10512 N 110TH EAST AVE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | OWASSO |
| Zip Code Of The Provider | 740556636 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 70 |
| Number Of Services | 2658 |
| Number Of Medicare Beneficiaries | 420 |
| Total Submitted Charge Amount | 226872 |
| Total Medicare Allowed Amount | 104087.19 |
| Total Medicare Payment Amount | 71166.29 |
| Total Medicare Standardized Payment Amount | 78343.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 483 |
| Number Of Medicare Beneficiaries With Drug Services | 146 |
| Total Drug Submitted ChargeAmount | 18339 |
| Total Drug Medicare AllowedAmount | 8707.48 |
| Total Drug Medicare PaymentAmount | 7668.85 |
| Total Drug Medicare Standardized Payment Amount | 7668.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 2175 |
| Number Of Medicare Beneficiaries With Medical Services | 420 |
| Total Medical Submitted Charge Amount | 208533 |
| Total Medical Medicare Allowed Amount | 95379.71 |
| Total Medical Medicare Payment Amount | 63497.44 |
| Total Medical Medicare Standardized Payment Amount | 70674.89 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 206 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 54 |
| Number Of Female Beneficiaries | 229 |
| Number Of Male Beneficiaries | 191 |
| Number Of Non Hispanic White Beneficiaries | 382 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 19 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 389 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 31 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1689 |