| National Provider Identifier [NPI]: | 1568454171 |
| Last Name Of The Provider | RICHARDSON |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M D |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2660 E MAIN ST STE 104 |
| Street Address 2 Of The Provider | |
| City Of The Provider | VENTURA |
| Zip Code Of The Provider | 930032893 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Obstetrics/Gynecology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 1718 |
| Number Of Medicare Beneficiaries | 94 |
| Total Submitted Charge Amount | 135350 |
| Total Medicare Allowed Amount | 75464.5 |
| Total Medicare Payment Amount | 56739.91 |
| Total Medicare Standardized Payment Amount | 53335.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1245 |
| Number Of Medicare Beneficiaries With Drug Services | 41 |
| Total Drug Submitted ChargeAmount | 24210 |
| Total Drug Medicare AllowedAmount | 19701.03 |
| Total Drug Medicare PaymentAmount | 15901.53 |
| Total Drug Medicare Standardized Payment Amount | 15901.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 473 |
| Number Of Medicare Beneficiaries With Medical Services | 94 |
| Total Medical Submitted Charge Amount | 111140 |
| Total Medical Medicare Allowed Amount | 55763.47 |
| Total Medical Medicare Payment Amount | 40838.38 |
| Total Medical Medicare Standardized Payment Amount | 37434.31 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 48 |
| Number Of Beneficiaries Age 75 to 84 | 29 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 77 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9714 |