| National Provider Identifier [NPI]: | 1659363752 |
| Last Name Of The Provider | RICHARDSON |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2535 HALE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | AVON |
| Zip Code Of The Provider | 440111856 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 2787 |
| Number Of Medicare Beneficiaries | 704 |
| Total Submitted Charge Amount | 342313 |
| Total Medicare Allowed Amount | 205878.79 |
| Total Medicare Payment Amount | 152766.65 |
| Total Medicare Standardized Payment Amount | 157988.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 146 |
| Number Of Medicare Beneficiaries With Drug Services | 93 |
| Total Drug Submitted ChargeAmount | 4924 |
| Total Drug Medicare AllowedAmount | 3459.17 |
| Total Drug Medicare PaymentAmount | 3261.32 |
| Total Drug Medicare Standardized Payment Amount | 3261.32 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 2641 |
| Number Of Medicare Beneficiaries With Medical Services | 704 |
| Total Medical Submitted Charge Amount | 337389 |
| Total Medical Medicare Allowed Amount | 202419.62 |
| Total Medical Medicare Payment Amount | 149505.33 |
| Total Medical Medicare Standardized Payment Amount | 154726.73 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | 232 |
| Number Of Beneficiaries Age 75 to 84 | 195 |
| Number Of Beneficiaries Age Greater 84 | 184 |
| Number Of Female Beneficiaries | 405 |
| Number Of Male Beneficiaries | 299 |
| Number Of Non Hispanic White Beneficiaries | 651 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 488 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 216 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 33 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8172 |