| National Provider Identifier [NPI]: | 1275572133 |
| Last Name Of The Provider | KOESEL |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 545 NE 47TH AVE |
| Street Address 2 Of The Provider | SUITE 215 |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 972132238 |
| 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 | 148 |
| Number Of Services | 3319 |
| Number Of Medicare Beneficiaries | 1879 |
| Total Submitted Charge Amount | 465599.9 |
| Total Medicare Allowed Amount | 130150.84 |
| Total Medicare Payment Amount | 97160.79 |
| Total Medicare Standardized Payment Amount | 98445.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 942 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 423.9 |
| Total Drug Medicare AllowedAmount | 388.83 |
| Total Drug Medicare PaymentAmount | 304.84 |
| Total Drug Medicare Standardized Payment Amount | 304.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 144 |
| Number Of Medical Services | 2377 |
| Number Of Medicare Beneficiaries With Medical Services | 1879 |
| Total Medical Submitted Charge Amount | 465176 |
| Total Medical Medicare Allowed Amount | 129762.01 |
| Total Medical Medicare Payment Amount | 96855.95 |
| Total Medical Medicare Standardized Payment Amount | 98140.21 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 409 |
| Number Of Beneficiaries Age 65 to 74 | 717 |
| Number Of Beneficiaries Age 75 to 84 | 465 |
| Number Of Beneficiaries Age Greater 84 | 288 |
| Number Of Female Beneficiaries | 1090 |
| Number Of Male Beneficiaries | 789 |
| Number Of Non Hispanic White Beneficiaries | 1641 |
| Number Of Black or African American Beneficiaries | 77 |
| Number Of AsianPacific Islander Beneficiaries | 65 |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | 17 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1318 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 561 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4276 |