| National Provider Identifier [NPI]: | 1013993013 |
| Last Name Of The Provider | LARSON |
| First Name Of The Provider | PAUL |
| 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 | 325 N COMMERCIAL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEENAH |
| Zip Code Of The Provider | 549562665 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 156 |
| Number Of Services | 4229 |
| Number Of Medicare Beneficiaries | 2798 |
| Total Submitted Charge Amount | 699365 |
| Total Medicare Allowed Amount | 90340.04 |
| Total Medicare Payment Amount | 67675.11 |
| Total Medicare Standardized Payment Amount | 70822.3 |
| 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 | 156 |
| Number Of Medical Services | 4229 |
| Number Of Medicare Beneficiaries With Medical Services | 2798 |
| Total Medical Submitted Charge Amount | 699365 |
| Total Medical Medicare Allowed Amount | 90340.04 |
| Total Medical Medicare Payment Amount | 67675.11 |
| Total Medical Medicare Standardized Payment Amount | 70822.3 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 500 |
| Number Of Beneficiaries Age 65 to 74 | 926 |
| Number Of Beneficiaries Age 75 to 84 | 801 |
| Number Of Beneficiaries Age Greater 84 | 571 |
| Number Of Female Beneficiaries | 1661 |
| Number Of Male Beneficiaries | 1137 |
| Number Of Non Hispanic White Beneficiaries | 2692 |
| Number Of Black or African American Beneficiaries | 21 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1982 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 816 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4467 |