| National Provider Identifier [NPI]: | 1508897422 |
| Last Name Of The Provider | LARSON |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10150 SE 32ND AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MILWAUKIE |
| Zip Code Of The Provider | 972226516 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 112 |
| Number Of Services | 2874 |
| Number Of Medicare Beneficiaries | 1537 |
| Total Submitted Charge Amount | 177339.2 |
| Total Medicare Allowed Amount | 57023.72 |
| Total Medicare Payment Amount | 40380.55 |
| Total Medicare Standardized Payment Amount | 41441.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 996 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 448.2 |
| Total Drug Medicare AllowedAmount | 171.09 |
| Total Drug Medicare PaymentAmount | 134.13 |
| Total Drug Medicare Standardized Payment Amount | 134.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 1878 |
| Number Of Medicare Beneficiaries With Medical Services | 1537 |
| Total Medical Submitted Charge Amount | 176891 |
| Total Medical Medicare Allowed Amount | 56852.63 |
| Total Medical Medicare Payment Amount | 40246.42 |
| Total Medical Medicare Standardized Payment Amount | 41307.12 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 341 |
| Number Of Beneficiaries Age 65 to 74 | 576 |
| Number Of Beneficiaries Age 75 to 84 | 374 |
| Number Of Beneficiaries Age Greater 84 | 246 |
| Number Of Female Beneficiaries | 877 |
| Number Of Male Beneficiaries | 660 |
| Number Of Non Hispanic White Beneficiaries | 1337 |
| Number Of Black or African American Beneficiaries | 68 |
| Number Of AsianPacific Islander Beneficiaries | 45 |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1082 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 455 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5563 |