| National Provider Identifier [NPI]: | 1891799318 |
| Last Name Of The Provider | HEROLD |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6028 S RIDGELINE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | SOUTH OGDEN |
| Zip Code Of The Provider | 844056914 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 4641 |
| Number Of Medicare Beneficiaries | 445 |
| Total Submitted Charge Amount | 468748 |
| Total Medicare Allowed Amount | 200851.68 |
| Total Medicare Payment Amount | 155632.86 |
| Total Medicare Standardized Payment Amount | 162625.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 297 |
| Number Of Medicare Beneficiaries With Drug Services | 208 |
| Total Drug Submitted ChargeAmount | 30225 |
| Total Drug Medicare AllowedAmount | 11364.66 |
| Total Drug Medicare PaymentAmount | 11102.91 |
| Total Drug Medicare Standardized Payment Amount | 11102.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 4344 |
| Number Of Medicare Beneficiaries With Medical Services | 445 |
| Total Medical Submitted Charge Amount | 438523 |
| Total Medical Medicare Allowed Amount | 189487.02 |
| Total Medical Medicare Payment Amount | 144529.95 |
| Total Medical Medicare Standardized Payment Amount | 151522.47 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 161 |
| Number Of Beneficiaries Age 75 to 84 | 160 |
| Number Of Beneficiaries Age Greater 84 | 109 |
| Number Of Female Beneficiaries | 197 |
| Number Of Male Beneficiaries | 248 |
| Number Of Non Hispanic White Beneficiaries | 409 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 433 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0919 |