| National Provider Identifier [NPI]: | 1477637452 |
| Last Name Of The Provider | BRUNEY |
| First Name Of The Provider | RUSSELL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3050 MONTVALE DR STE A |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 627046924 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 208 |
| Number Of Services | 20219 |
| Number Of Medicare Beneficiaries | 4417 |
| Total Submitted Charge Amount | 2432115.73 |
| Total Medicare Allowed Amount | 362537.29 |
| Total Medicare Payment Amount | 273952.77 |
| Total Medicare Standardized Payment Amount | 292112.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 12861 |
| Number Of Medicare Beneficiaries With Drug Services | 211 |
| Total Drug Submitted ChargeAmount | 35788.92 |
| Total Drug Medicare AllowedAmount | 4892.16 |
| Total Drug Medicare PaymentAmount | 3754.32 |
| Total Drug Medicare Standardized Payment Amount | 3754.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 203 |
| Number Of Medical Services | 7358 |
| Number Of Medicare Beneficiaries With Medical Services | 4417 |
| Total Medical Submitted Charge Amount | 2396326.81 |
| Total Medical Medicare Allowed Amount | 357645.13 |
| Total Medical Medicare Payment Amount | 270198.45 |
| Total Medical Medicare Standardized Payment Amount | 288358.62 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 746 |
| Number Of Beneficiaries Age 65 to 74 | 1638 |
| Number Of Beneficiaries Age 75 to 84 | 1318 |
| Number Of Beneficiaries Age Greater 84 | 715 |
| Number Of Female Beneficiaries | 2814 |
| Number Of Male Beneficiaries | 1603 |
| Number Of Non Hispanic White Beneficiaries | 4252 |
| Number Of Black or African American Beneficiaries | 102 |
| 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 | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3274 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1143 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3866 |