| National Provider Identifier [NPI]: | 1700809266 |
| Last Name Of The Provider | OSTERHOLM |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7100 W CENTER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | OMAHA |
| Zip Code Of The Provider | 681062700 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 117 |
| Number Of Services | 16667 |
| Number Of Medicare Beneficiaries | 991 |
| Total Submitted Charge Amount | 1062218 |
| Total Medicare Allowed Amount | 447922.7 |
| Total Medicare Payment Amount | 340639.78 |
| Total Medicare Standardized Payment Amount | 368399.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 1337 |
| Number Of Medicare Beneficiaries With Drug Services | 476 |
| Total Drug Submitted ChargeAmount | 29338 |
| Total Drug Medicare AllowedAmount | 19482.28 |
| Total Drug Medicare PaymentAmount | 18453.82 |
| Total Drug Medicare Standardized Payment Amount | 18453.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 99 |
| Number Of Medical Services | 15330 |
| Number Of Medicare Beneficiaries With Medical Services | 991 |
| Total Medical Submitted Charge Amount | 1032880 |
| Total Medical Medicare Allowed Amount | 428440.42 |
| Total Medical Medicare Payment Amount | 322185.96 |
| Total Medical Medicare Standardized Payment Amount | 349945.57 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 385 |
| Number Of Beneficiaries Age 75 to 84 | 356 |
| Number Of Beneficiaries Age Greater 84 | 189 |
| Number Of Female Beneficiaries | 561 |
| Number Of Male Beneficiaries | 430 |
| Number Of Non Hispanic White Beneficiaries | 927 |
| Number Of Black or African American Beneficiaries | 31 |
| 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 | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 926 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 65 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1954 |