| National Provider Identifier [NPI]: | 1104892454 |
| Last Name Of The Provider | RUSSELL |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1310 LAS TABLAS RD |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | TEMPLETON |
| Zip Code Of The Provider | 934659737 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 206 |
| Number Of Services | 12129 |
| Number Of Medicare Beneficiaries | 2498 |
| Total Submitted Charge Amount | 1862267.85 |
| Total Medicare Allowed Amount | 480217.15 |
| Total Medicare Payment Amount | 370515.38 |
| Total Medicare Standardized Payment Amount | 359860.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 8076 |
| Number Of Medicare Beneficiaries With Drug Services | 151 |
| Total Drug Submitted ChargeAmount | 24348 |
| Total Drug Medicare AllowedAmount | 4068.26 |
| Total Drug Medicare PaymentAmount | 3165.69 |
| Total Drug Medicare Standardized Payment Amount | 3165.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 199 |
| Number Of Medical Services | 4053 |
| Number Of Medicare Beneficiaries With Medical Services | 2497 |
| Total Medical Submitted Charge Amount | 1837919.85 |
| Total Medical Medicare Allowed Amount | 476148.89 |
| Total Medical Medicare Payment Amount | 367349.69 |
| Total Medical Medicare Standardized Payment Amount | 356694.33 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 306 |
| Number Of Beneficiaries Age 65 to 74 | 1128 |
| Number Of Beneficiaries Age 75 to 84 | 739 |
| Number Of Beneficiaries Age Greater 84 | 325 |
| Number Of Female Beneficiaries | 1563 |
| Number Of Male Beneficiaries | 935 |
| Number Of Non Hispanic White Beneficiaries | 2211 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 186 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2064 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 434 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1686 |