| National Provider Identifier [NPI]: | 1104821800 |
| Last Name Of The Provider | DAVID |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 117 MEDICAL CIRCLE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ATHENS |
| Zip Code Of The Provider | 75751 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 125 |
| Number Of Services | 4672 |
| Number Of Medicare Beneficiaries | 484 |
| Total Submitted Charge Amount | 354023.74 |
| Total Medicare Allowed Amount | 196953.88 |
| Total Medicare Payment Amount | 146734.36 |
| Total Medicare Standardized Payment Amount | 151434.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 500 |
| Number Of Medicare Beneficiaries With Drug Services | 169 |
| Total Drug Submitted ChargeAmount | 11314.24 |
| Total Drug Medicare AllowedAmount | 7990.52 |
| Total Drug Medicare PaymentAmount | 7104.21 |
| Total Drug Medicare Standardized Payment Amount | 7104.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 4172 |
| Number Of Medicare Beneficiaries With Medical Services | 484 |
| Total Medical Submitted Charge Amount | 342709.5 |
| Total Medical Medicare Allowed Amount | 188963.36 |
| Total Medical Medicare Payment Amount | 139630.15 |
| Total Medical Medicare Standardized Payment Amount | 144330.09 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 45 |
| Number Of Beneficiaries Age 65 to 74 | 174 |
| Number Of Beneficiaries Age 75 to 84 | 179 |
| Number Of Beneficiaries Age Greater 84 | 86 |
| Number Of Female Beneficiaries | 269 |
| Number Of Male Beneficiaries | 215 |
| Number Of Non Hispanic White Beneficiaries | 453 |
| 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 | 409 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 34 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3145 |