| National Provider Identifier [NPI]: | 1528134319 |
| Last Name Of The Provider | EDMISTON |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2375 E PRATER WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | SPARKS |
| Zip Code Of The Provider | 894349641 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 5250 |
| Number Of Medicare Beneficiaries | 2074 |
| Total Submitted Charge Amount | 601118 |
| Total Medicare Allowed Amount | 135778.17 |
| Total Medicare Payment Amount | 106999.48 |
| Total Medicare Standardized Payment Amount | 106507.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 150 |
| Number Of Medical Services | 5250 |
| Number Of Medicare Beneficiaries With Medical Services | 2074 |
| Total Medical Submitted Charge Amount | 601118 |
| Total Medical Medicare Allowed Amount | 135778.17 |
| Total Medical Medicare Payment Amount | 106999.48 |
| Total Medical Medicare Standardized Payment Amount | 106507.96 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 349 |
| Number Of Beneficiaries Age 65 to 74 | 830 |
| Number Of Beneficiaries Age 75 to 84 | 575 |
| Number Of Beneficiaries Age Greater 84 | 320 |
| Number Of Female Beneficiaries | 1329 |
| Number Of Male Beneficiaries | 745 |
| Number Of Non Hispanic White Beneficiaries | 1787 |
| Number Of Black or African American Beneficiaries | 42 |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 156 |
| Number Of American Indian Alaska Native Beneficiaries | 32 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1673 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 401 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3978 |