| National Provider Identifier [NPI]: | 1851310510 |
| Last Name Of The Provider | LARSON |
| First Name Of The Provider | LANCE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 222 112TH AVE NE |
| Street Address 2 Of The Provider | STE 101 |
| City Of The Provider | BELLEVUE |
| Zip Code Of The Provider | 980045856 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 3514 |
| Number Of Medicare Beneficiaries | 576 |
| Total Submitted Charge Amount | 399782.77 |
| Total Medicare Allowed Amount | 129167.46 |
| Total Medicare Payment Amount | 89816.92 |
| Total Medicare Standardized Payment Amount | 85814.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 20 |
| Number Of Drug Services | 1110 |
| Number Of Medicare Beneficiaries With Drug Services | 146 |
| Total Drug Submitted ChargeAmount | 23973.77 |
| Total Drug Medicare AllowedAmount | 10700.23 |
| Total Drug Medicare PaymentAmount | 9090.44 |
| Total Drug Medicare Standardized Payment Amount | 9090.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 2404 |
| Number Of Medicare Beneficiaries With Medical Services | 568 |
| Total Medical Submitted Charge Amount | 375809 |
| Total Medical Medicare Allowed Amount | 118467.23 |
| Total Medical Medicare Payment Amount | 80726.48 |
| Total Medical Medicare Standardized Payment Amount | 76723.79 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 23 |
| Number Of Beneficiaries Age 65 to 74 | 228 |
| Number Of Beneficiaries Age 75 to 84 | 192 |
| Number Of Beneficiaries Age Greater 84 | 133 |
| Number Of Female Beneficiaries | 268 |
| Number Of Male Beneficiaries | 308 |
| Number Of Non Hispanic White Beneficiaries | 523 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| 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 | 547 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 15 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 23 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0365 |