| National Provider Identifier [NPI]: | 1770522278 |
| Last Name Of The Provider | LICHTENSTEIN |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2700 UNIVERSITY SQUARE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336125513 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 232 |
| Number Of Services | 69933 |
| Number Of Medicare Beneficiaries | 11775 |
| Total Submitted Charge Amount | 3797047 |
| Total Medicare Allowed Amount | 1402599.24 |
| Total Medicare Payment Amount | 1088956.95 |
| Total Medicare Standardized Payment Amount | 1118958.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 50453 |
| Number Of Medicare Beneficiaries With Drug Services | 835 |
| Total Drug Submitted ChargeAmount | 61632 |
| Total Drug Medicare AllowedAmount | 15833.87 |
| Total Drug Medicare PaymentAmount | 12406.6 |
| Total Drug Medicare Standardized Payment Amount | 12406.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 229 |
| Number Of Medical Services | 19480 |
| Number Of Medicare Beneficiaries With Medical Services | 11775 |
| Total Medical Submitted Charge Amount | 3735415 |
| Total Medical Medicare Allowed Amount | 1386765.37 |
| Total Medical Medicare Payment Amount | 1076550.35 |
| Total Medical Medicare Standardized Payment Amount | 1106551.63 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 760 |
| Number Of Beneficiaries Age 65 to 74 | 4608 |
| Number Of Beneficiaries Age 75 to 84 | 4100 |
| Number Of Beneficiaries Age Greater 84 | 2307 |
| Number Of Female Beneficiaries | 7020 |
| Number Of Male Beneficiaries | 4755 |
| Number Of Non Hispanic White Beneficiaries | 10897 |
| Number Of Black or African American Beneficiaries | 344 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 306 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 156 |
| Number Of Beneficiaries With Medicare Only Entitlement | 10624 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1151 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3115 |