| National Provider Identifier [NPI]: | 1669449443 |
| Last Name Of The Provider | RICHARDSON |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 215 E MANSION ST |
| Street Address 2 Of The Provider | SUITE 1E |
| City Of The Provider | MARSHALL |
| Zip Code Of The Provider | 490681559 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 2277 |
| Number Of Medicare Beneficiaries | 332 |
| Total Submitted Charge Amount | 231806 |
| Total Medicare Allowed Amount | 142436.31 |
| Total Medicare Payment Amount | 100140.01 |
| Total Medicare Standardized Payment Amount | 103714.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 151 |
| Number Of Medicare Beneficiaries With Drug Services | 115 |
| Total Drug Submitted ChargeAmount | 6742 |
| Total Drug Medicare AllowedAmount | 5149.08 |
| Total Drug Medicare PaymentAmount | 5033 |
| Total Drug Medicare Standardized Payment Amount | 5033 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 2126 |
| Number Of Medicare Beneficiaries With Medical Services | 332 |
| Total Medical Submitted Charge Amount | 225064 |
| Total Medical Medicare Allowed Amount | 137287.23 |
| Total Medical Medicare Payment Amount | 95107.01 |
| Total Medical Medicare Standardized Payment Amount | 98681.33 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 129 |
| Number Of Beneficiaries Age 75 to 84 | 105 |
| Number Of Beneficiaries Age Greater 84 | 61 |
| Number Of Female Beneficiaries | 196 |
| Number Of Male Beneficiaries | 136 |
| Number Of Non Hispanic White Beneficiaries | 317 |
| Number Of Black or African American Beneficiaries | |
| 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 | 268 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 38 |
| 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 | 1.2866 |