| National Provider Identifier [NPI]: | 1922022649 |
| Last Name Of The Provider | RICHARDSON |
| First Name Of The Provider | LARS |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1101 BEACON STREET |
| Street Address 2 Of The Provider | SUITE 5W |
| City Of The Provider | BROOKLINE |
| Zip Code Of The Provider | 02446 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Sports Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 29 |
| Number Of Services | 1829 |
| Number Of Medicare Beneficiaries | 237 |
| Total Submitted Charge Amount | 244969.68 |
| Total Medicare Allowed Amount | 62526.78 |
| Total Medicare Payment Amount | 45265.07 |
| Total Medicare Standardized Payment Amount | 42510.98 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1222 |
| Number Of Medicare Beneficiaries With Drug Services | 104 |
| Total Drug Submitted ChargeAmount | 7700 |
| Total Drug Medicare AllowedAmount | 1836.29 |
| Total Drug Medicare PaymentAmount | 1398.02 |
| Total Drug Medicare Standardized Payment Amount | 1398.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 26 |
| Number Of Medical Services | 607 |
| Number Of Medicare Beneficiaries With Medical Services | 237 |
| Total Medical Submitted Charge Amount | 237269.68 |
| Total Medical Medicare Allowed Amount | 60690.49 |
| Total Medical Medicare Payment Amount | 43867.05 |
| Total Medical Medicare Standardized Payment Amount | 41112.96 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 109 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 120 |
| Number Of Male Beneficiaries | 117 |
| Number Of Non Hispanic White Beneficiaries | 194 |
| Number Of Black or African American Beneficiaries | 15 |
| 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 | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 190 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 47 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 67 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9046 |