| National Provider Identifier [NPI]: | 1194729582 |
| Last Name Of The Provider | LARSON |
| First Name Of The Provider | BRADLEY |
| 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 | 157 CLINIC AVE |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | CARROLLTON |
| Zip Code Of The Provider | 301174413 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 124 |
| Number Of Services | 99048 |
| Number Of Medicare Beneficiaries | 628 |
| Total Submitted Charge Amount | 5732605.5 |
| Total Medicare Allowed Amount | 1954902.17 |
| Total Medicare Payment Amount | 1488486.39 |
| Total Medicare Standardized Payment Amount | 1500363.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 67 |
| Number Of Drug Services | 90117 |
| Number Of Medicare Beneficiaries With Drug Services | 195 |
| Total Drug Submitted ChargeAmount | 4430923.5 |
| Total Drug Medicare AllowedAmount | 1566665.67 |
| Total Drug Medicare PaymentAmount | 1190923.36 |
| Total Drug Medicare Standardized Payment Amount | 1190923.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 57 |
| Number Of Medical Services | 8931 |
| Number Of Medicare Beneficiaries With Medical Services | 628 |
| Total Medical Submitted Charge Amount | 1301682 |
| Total Medical Medicare Allowed Amount | 388236.5 |
| Total Medical Medicare Payment Amount | 297563.03 |
| Total Medical Medicare Standardized Payment Amount | 309439.65 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 284 |
| Number Of Beneficiaries Age 75 to 84 | 195 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 390 |
| Number Of Male Beneficiaries | 238 |
| Number Of Non Hispanic White Beneficiaries | 551 |
| Number Of Black or African American Beneficiaries | 62 |
| 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 | 476 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 152 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 44 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.7869 |