| National Provider Identifier [NPI]: | 1710988183 |
| Last Name Of The Provider | WHITAKER |
| First Name Of The Provider | RUSSELL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 MEDICAL CENTER DRIVE |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | GADSDEN |
| Zip Code Of The Provider | 35903 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 3801 |
| Number Of Medicare Beneficiaries | 1356 |
| Total Submitted Charge Amount | 747332 |
| Total Medicare Allowed Amount | 263238.26 |
| Total Medicare Payment Amount | 196518.3 |
| Total Medicare Standardized Payment Amount | 213593.63 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 413 |
| Number Of Medicare Beneficiaries With Drug Services | 103 |
| Total Drug Submitted ChargeAmount | 54921 |
| Total Drug Medicare AllowedAmount | 21859.76 |
| Total Drug Medicare PaymentAmount | 16872.6 |
| Total Drug Medicare Standardized Payment Amount | 16872.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 3388 |
| Number Of Medicare Beneficiaries With Medical Services | 1356 |
| Total Medical Submitted Charge Amount | 692411 |
| Total Medical Medicare Allowed Amount | 241378.5 |
| Total Medical Medicare Payment Amount | 179645.7 |
| Total Medical Medicare Standardized Payment Amount | 196721.03 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 298 |
| Number Of Beneficiaries Age 65 to 74 | 487 |
| Number Of Beneficiaries Age 75 to 84 | 381 |
| Number Of Beneficiaries Age Greater 84 | 190 |
| Number Of Female Beneficiaries | 711 |
| Number Of Male Beneficiaries | 645 |
| Number Of Non Hispanic White Beneficiaries | 1221 |
| Number Of Black or African American Beneficiaries | 120 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 997 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 359 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 65 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7069 |