| National Provider Identifier [NPI]: | 1902003932 |
| Last Name Of The Provider | DIRCKS |
| First Name Of The Provider | COLIN |
| 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 | 2165 BASQUE DR SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SMYRNA |
| Zip Code Of The Provider | 300806508 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 1394 |
| Number Of Medicare Beneficiaries | 758 |
| Total Submitted Charge Amount | 1351198 |
| Total Medicare Allowed Amount | 149095.92 |
| Total Medicare Payment Amount | 115517.11 |
| Total Medicare Standardized Payment Amount | 116283.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 32 |
| Number Of Medical Services | 1394 |
| Number Of Medicare Beneficiaries With Medical Services | 758 |
| Total Medical Submitted Charge Amount | 1351198 |
| Total Medical Medicare Allowed Amount | 149095.92 |
| Total Medical Medicare Payment Amount | 115517.11 |
| Total Medical Medicare Standardized Payment Amount | 116283.24 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 152 |
| Number Of Beneficiaries Age 65 to 74 | 238 |
| Number Of Beneficiaries Age 75 to 84 | 198 |
| Number Of Beneficiaries Age Greater 84 | 170 |
| Number Of Female Beneficiaries | 449 |
| Number Of Male Beneficiaries | 309 |
| Number Of Non Hispanic White Beneficiaries | 502 |
| Number Of Black or African American Beneficiaries | 234 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 11 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 599 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 159 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 28 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7799 |