| National Provider Identifier [NPI]: | 1386676104 |
| Last Name Of The Provider | RICHARD |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D., P.A. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5009 THOMPSON TER |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | COLLEYVILLE |
| Zip Code Of The Provider | 760345850 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 5172 |
| Number Of Medicare Beneficiaries | 236 |
| Total Submitted Charge Amount | 339210 |
| Total Medicare Allowed Amount | 157682.23 |
| Total Medicare Payment Amount | 116229.29 |
| Total Medicare Standardized Payment Amount | 120087.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 1965 |
| Number Of Medicare Beneficiaries With Drug Services | 142 |
| Total Drug Submitted ChargeAmount | 63547 |
| Total Drug Medicare AllowedAmount | 16464.68 |
| Total Drug Medicare PaymentAmount | 12957.85 |
| Total Drug Medicare Standardized Payment Amount | 12957.85 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 45 |
| Number Of Medical Services | 3207 |
| Number Of Medicare Beneficiaries With Medical Services | 236 |
| Total Medical Submitted Charge Amount | 275663 |
| Total Medical Medicare Allowed Amount | 141217.55 |
| Total Medical Medicare Payment Amount | 103271.44 |
| Total Medical Medicare Standardized Payment Amount | 107129.18 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 122 |
| Number Of Beneficiaries Age 75 to 84 | 94 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 116 |
| Number Of Male Beneficiaries | 120 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9491 |