| National Provider Identifier [NPI]: | 1104864354 |
| Last Name Of The Provider | LARSON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1215 SIDNEY ST |
| Street Address 2 Of The Provider | SUITE 203 |
| City Of The Provider | BATESVILLE |
| Zip Code Of The Provider | 725017203 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 3852 |
| Number Of Medicare Beneficiaries | 623 |
| Total Submitted Charge Amount | 1094913.5 |
| Total Medicare Allowed Amount | 287900.87 |
| Total Medicare Payment Amount | 217008.92 |
| Total Medicare Standardized Payment Amount | 200196.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 3852 |
| Number Of Medicare Beneficiaries With Medical Services | 623 |
| Total Medical Submitted Charge Amount | 1094913.5 |
| Total Medical Medicare Allowed Amount | 287900.87 |
| Total Medical Medicare Payment Amount | 217008.92 |
| Total Medical Medicare Standardized Payment Amount | 200196.03 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 348 |
| Number Of Beneficiaries Age 65 to 74 | 147 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 427 |
| Number Of Male Beneficiaries | 196 |
| Number Of Non Hispanic White Beneficiaries | 599 |
| 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 | 328 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 295 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3508 |