| National Provider Identifier [NPI]: | 1598792509 |
| Last Name Of The Provider | LARSON |
| First Name Of The Provider | EARL |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 123 W 31ST ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | KEARNEY |
| Zip Code Of The Provider | 688472916 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 7174 |
| Number Of Medicare Beneficiaries | 970 |
| Total Submitted Charge Amount | 461486 |
| Total Medicare Allowed Amount | 302701.27 |
| Total Medicare Payment Amount | 222853.53 |
| Total Medicare Standardized Payment Amount | 238820.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 2350 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 138649 |
| Total Drug Medicare AllowedAmount | 105668.68 |
| Total Drug Medicare PaymentAmount | 80374.39 |
| Total Drug Medicare Standardized Payment Amount | 80374.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 85 |
| Number Of Medical Services | 4824 |
| Number Of Medicare Beneficiaries With Medical Services | 970 |
| Total Medical Submitted Charge Amount | 322837 |
| Total Medical Medicare Allowed Amount | 197032.59 |
| Total Medical Medicare Payment Amount | 142479.14 |
| Total Medical Medicare Standardized Payment Amount | 158446.09 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 24 |
| Number Of Beneficiaries Age 65 to 74 | 313 |
| Number Of Beneficiaries Age 75 to 84 | 398 |
| Number Of Beneficiaries Age Greater 84 | 235 |
| Number Of Female Beneficiaries | 183 |
| Number Of Male Beneficiaries | 787 |
| Number Of Non Hispanic White Beneficiaries | 955 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 917 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0616 |