| National Provider Identifier [NPI]: | 1639336746 |
| Last Name Of The Provider | STANLEY |
| First Name Of The Provider | RUSSELL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8042 WURZBACH RD STE 450 |
| Street Address 2 Of The Provider | PHYSICIANS PLAZA II |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782293808 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 55 |
| Number Of Services | 2619 |
| Number Of Medicare Beneficiaries | 593 |
| Total Submitted Charge Amount | 277448 |
| Total Medicare Allowed Amount | 190055.46 |
| Total Medicare Payment Amount | 135715.36 |
| Total Medicare Standardized Payment Amount | 146783.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 71 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 710 |
| Total Drug Medicare AllowedAmount | 121.66 |
| Total Drug Medicare PaymentAmount | 95.45 |
| Total Drug Medicare Standardized Payment Amount | 95.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 2548 |
| Number Of Medicare Beneficiaries With Medical Services | 593 |
| Total Medical Submitted Charge Amount | 276738 |
| Total Medical Medicare Allowed Amount | 189933.8 |
| Total Medical Medicare Payment Amount | 135619.91 |
| Total Medical Medicare Standardized Payment Amount | 146687.78 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | 271 |
| Number Of Beneficiaries Age 75 to 84 | 176 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 324 |
| Number Of Male Beneficiaries | 269 |
| Number Of Non Hispanic White Beneficiaries | 305 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 237 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 514 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 79 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 74 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.8718 |