| National Provider Identifier [NPI]: | 1871799395 |
| Last Name Of The Provider | RICHARDSON |
| First Name Of The Provider | BRETT |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 501 HOWARD AVE |
| Street Address 2 Of The Provider | SUITE F2 |
| City Of The Provider | ALTOONA |
| Zip Code Of The Provider | 166014810 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 178 |
| Number Of Services | 12003 |
| Number Of Medicare Beneficiaries | 4453 |
| Total Submitted Charge Amount | 852555 |
| Total Medicare Allowed Amount | 238762.9 |
| Total Medicare Payment Amount | 184367.98 |
| Total Medicare Standardized Payment Amount | 200429.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 5478 |
| Number Of Medicare Beneficiaries With Drug Services | 96 |
| Total Drug Submitted ChargeAmount | 6466.5 |
| Total Drug Medicare AllowedAmount | 1997.59 |
| Total Drug Medicare PaymentAmount | 1557.54 |
| Total Drug Medicare Standardized Payment Amount | 1557.54 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 173 |
| Number Of Medical Services | 6525 |
| Number Of Medicare Beneficiaries With Medical Services | 4453 |
| Total Medical Submitted Charge Amount | 846088.5 |
| Total Medical Medicare Allowed Amount | 236765.31 |
| Total Medical Medicare Payment Amount | 182810.44 |
| Total Medical Medicare Standardized Payment Amount | 198871.86 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 650 |
| Number Of Beneficiaries Age 65 to 74 | 1625 |
| Number Of Beneficiaries Age 75 to 84 | 1362 |
| Number Of Beneficiaries Age Greater 84 | 816 |
| Number Of Female Beneficiaries | 2778 |
| Number Of Male Beneficiaries | 1675 |
| Number Of Non Hispanic White Beneficiaries | 4226 |
| Number Of Black or African American Beneficiaries | 111 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3588 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 865 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3675 |