| National Provider Identifier [NPI]: | 1568689651 |
| Last Name Of The Provider | RUSSELL |
| First Name Of The Provider | DANA |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | CRNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 40900 MERCHANTS LN |
| Street Address 2 Of The Provider | SUITE 207 |
| City Of The Provider | LEONARDTOWN |
| Zip Code Of The Provider | 206503700 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 1796 |
| Number Of Medicare Beneficiaries | 496 |
| Total Submitted Charge Amount | 241118 |
| Total Medicare Allowed Amount | 129410.73 |
| Total Medicare Payment Amount | 86306.07 |
| Total Medicare Standardized Payment Amount | 102120.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 174 |
| Number Of Medicare Beneficiaries With Drug Services | 134 |
| Total Drug Submitted ChargeAmount | 5089 |
| Total Drug Medicare AllowedAmount | 3685.99 |
| Total Drug Medicare PaymentAmount | 3551.56 |
| Total Drug Medicare Standardized Payment Amount | 3551.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 1622 |
| Number Of Medicare Beneficiaries With Medical Services | 496 |
| Total Medical Submitted Charge Amount | 236029 |
| Total Medical Medicare Allowed Amount | 125724.74 |
| Total Medical Medicare Payment Amount | 82754.51 |
| Total Medical Medicare Standardized Payment Amount | 98568.71 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 257 |
| Number Of Beneficiaries Age 75 to 84 | 151 |
| Number Of Beneficiaries Age Greater 84 | 55 |
| Number Of Female Beneficiaries | 334 |
| Number Of Male Beneficiaries | 162 |
| Number Of Non Hispanic White Beneficiaries | 472 |
| 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 | 453 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 43 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0051 |