| National Provider Identifier [NPI]: | 1568434173 |
| Last Name Of The Provider | DICKERSON |
| First Name Of The Provider | CAROL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8301 STATE LINE RD |
| Street Address 2 Of The Provider | #100 |
| City Of The Provider | KANSAS CITY |
| Zip Code Of The Provider | 641142025 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 969 |
| Number Of Medicare Beneficiaries | 572 |
| Total Submitted Charge Amount | 170245 |
| Total Medicare Allowed Amount | 92082.89 |
| Total Medicare Payment Amount | 68187.25 |
| Total Medicare Standardized Payment Amount | 84702.19 |
| 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 | 8 |
| Number Of Medical Services | 969 |
| Number Of Medicare Beneficiaries With Medical Services | 572 |
| Total Medical Submitted Charge Amount | 170245 |
| Total Medical Medicare Allowed Amount | 92082.89 |
| Total Medical Medicare Payment Amount | 68187.25 |
| Total Medical Medicare Standardized Payment Amount | 84702.19 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 113 |
| Number Of Beneficiaries Age 65 to 74 | 123 |
| Number Of Beneficiaries Age 75 to 84 | 145 |
| Number Of Beneficiaries Age Greater 84 | 191 |
| Number Of Female Beneficiaries | 356 |
| Number Of Male Beneficiaries | 216 |
| Number Of Non Hispanic White Beneficiaries | 481 |
| Number Of Black or African American Beneficiaries | 70 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 120 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 452 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 67 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 55 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 39 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.4165 |