| National Provider Identifier [NPI]: | 1265422851 |
| Last Name Of The Provider | LARSON |
| First Name Of The Provider | DAVID |
| 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 | 1215 DUFF AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | AMES |
| Zip Code Of The Provider | 500103014 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 224 |
| Number Of Services | 22629 |
| Number Of Medicare Beneficiaries | 5160 |
| Total Submitted Charge Amount | 1787958.76 |
| Total Medicare Allowed Amount | 513692.09 |
| Total Medicare Payment Amount | 398779.16 |
| Total Medicare Standardized Payment Amount | 436555.15 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 13536 |
| Number Of Medicare Beneficiaries With Drug Services | 219 |
| Total Drug Submitted ChargeAmount | 17258.76 |
| Total Drug Medicare AllowedAmount | 4323.56 |
| Total Drug Medicare PaymentAmount | 3381.58 |
| Total Drug Medicare Standardized Payment Amount | 3381.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 222 |
| Number Of Medical Services | 9093 |
| Number Of Medicare Beneficiaries With Medical Services | 5160 |
| Total Medical Submitted Charge Amount | 1770700 |
| Total Medical Medicare Allowed Amount | 509368.53 |
| Total Medical Medicare Payment Amount | 395397.58 |
| Total Medical Medicare Standardized Payment Amount | 433173.57 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 578 |
| Number Of Beneficiaries Age 65 to 74 | 1974 |
| Number Of Beneficiaries Age 75 to 84 | 1687 |
| Number Of Beneficiaries Age Greater 84 | 921 |
| Number Of Female Beneficiaries | 3336 |
| Number Of Male Beneficiaries | 1824 |
| Number Of Non Hispanic White Beneficiaries | 4975 |
| Number Of Black or African American Beneficiaries | 27 |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | 24 |
| Number Of Beneficiaries With Race Not Else where Classified | 55 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4384 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 776 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.292 |