| National Provider Identifier [NPI]: | 1215991120 |
| Last Name Of The Provider | RICHARDSON |
| First Name Of The Provider | LONDE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 222 15TH AVE SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PUYALLUP |
| Zip Code Of The Provider | 983723754 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 148 |
| Number Of Services | 9353 |
| Number Of Medicare Beneficiaries | 3133 |
| Total Submitted Charge Amount | 532592 |
| Total Medicare Allowed Amount | 164839.88 |
| Total Medicare Payment Amount | 125164.73 |
| Total Medicare Standardized Payment Amount | 125776.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 5096 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 10192 |
| Total Drug Medicare AllowedAmount | 990.47 |
| Total Drug Medicare PaymentAmount | 776.58 |
| Total Drug Medicare Standardized Payment Amount | 776.58 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 146 |
| Number Of Medical Services | 4257 |
| Number Of Medicare Beneficiaries With Medical Services | 3133 |
| Total Medical Submitted Charge Amount | 522400 |
| Total Medical Medicare Allowed Amount | 163849.41 |
| Total Medical Medicare Payment Amount | 124388.15 |
| Total Medical Medicare Standardized Payment Amount | 125000.21 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 458 |
| Number Of Beneficiaries Age 65 to 74 | 1205 |
| Number Of Beneficiaries Age 75 to 84 | 958 |
| Number Of Beneficiaries Age Greater 84 | 512 |
| Number Of Female Beneficiaries | 1945 |
| Number Of Male Beneficiaries | 1188 |
| Number Of Non Hispanic White Beneficiaries | 2832 |
| Number Of Black or African American Beneficiaries | 84 |
| Number Of AsianPacific Islander Beneficiaries | 78 |
| Number Of Hispanic Beneficiaries | 83 |
| Number Of American Indian Alaska Native Beneficiaries | 20 |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2531 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 602 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5687 |