| National Provider Identifier [NPI]: | 1477548618 |
| Last Name Of The Provider | DICK |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 619 S FLEISHEL AVE |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757012004 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 115 |
| Number Of Services | 13784 |
| Number Of Medicare Beneficiaries | 2442 |
| Total Submitted Charge Amount | 2490900.38 |
| Total Medicare Allowed Amount | 716632.15 |
| Total Medicare Payment Amount | 542724.78 |
| Total Medicare Standardized Payment Amount | 576927.28 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 6019 |
| Number Of Medicare Beneficiaries With Drug Services | 150 |
| Total Drug Submitted ChargeAmount | 66129.01 |
| Total Drug Medicare AllowedAmount | 23507.11 |
| Total Drug Medicare PaymentAmount | 18262.81 |
| Total Drug Medicare Standardized Payment Amount | 18262.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 111 |
| Number Of Medical Services | 7765 |
| Number Of Medicare Beneficiaries With Medical Services | 2442 |
| Total Medical Submitted Charge Amount | 2424771.37 |
| Total Medical Medicare Allowed Amount | 693125.04 |
| Total Medical Medicare Payment Amount | 524461.97 |
| Total Medical Medicare Standardized Payment Amount | 558664.47 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 259 |
| Number Of Beneficiaries Age 65 to 74 | 920 |
| Number Of Beneficiaries Age 75 to 84 | 863 |
| Number Of Beneficiaries Age Greater 84 | 400 |
| Number Of Female Beneficiaries | 1175 |
| Number Of Male Beneficiaries | 1267 |
| Number Of Non Hispanic White Beneficiaries | 2150 |
| Number Of Black or African American Beneficiaries | 222 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2060 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 382 |
| Percent Of With Atrial Fibrillation | 27 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 71 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5311 |