| National Provider Identifier [NPI]: | 1407876352 |
| Last Name Of The Provider | RICHEY |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 155 GLASSON WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRASS VALLEY |
| Zip Code Of The Provider | 959455723 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 240 |
| Number Of Services | 6573 |
| Number Of Medicare Beneficiaries | 3493 |
| Total Submitted Charge Amount | 574800 |
| Total Medicare Allowed Amount | 202455.21 |
| Total Medicare Payment Amount | 151571.14 |
| Total Medicare Standardized Payment Amount | 149422.34 |
| 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 | 240 |
| Number Of Medical Services | 6573 |
| Number Of Medicare Beneficiaries With Medical Services | 3493 |
| Total Medical Submitted Charge Amount | 574800 |
| Total Medical Medicare Allowed Amount | 202455.21 |
| Total Medical Medicare Payment Amount | 151571.14 |
| Total Medical Medicare Standardized Payment Amount | 149422.34 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 388 |
| Number Of Beneficiaries Age 65 to 74 | 1473 |
| Number Of Beneficiaries Age 75 to 84 | 1001 |
| Number Of Beneficiaries Age Greater 84 | 631 |
| Number Of Female Beneficiaries | 2190 |
| Number Of Male Beneficiaries | 1303 |
| Number Of Non Hispanic White Beneficiaries | 3299 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 93 |
| Number Of American Indian Alaska Native Beneficiaries | 34 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2939 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 554 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.2378 |