| National Provider Identifier [NPI]: | 1205014297 |
| Last Name Of The Provider | BICK-FORRESTER |
| First Name Of The Provider | JUSTIN |
| 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 | 1200 N STATE ST |
| Street Address 2 Of The Provider | ROOM 3550 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 900331029 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 211 |
| Number Of Services | 9989 |
| Number Of Medicare Beneficiaries | 4142 |
| Total Submitted Charge Amount | 1254084.8 |
| Total Medicare Allowed Amount | 269994.63 |
| Total Medicare Payment Amount | 198519.12 |
| Total Medicare Standardized Payment Amount | 185554.84 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2640 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 2620.8 |
| Total Drug Medicare AllowedAmount | 501.62 |
| Total Drug Medicare PaymentAmount | 393.25 |
| Total Drug Medicare Standardized Payment Amount | 393.25 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 209 |
| Number Of Medical Services | 7349 |
| Number Of Medicare Beneficiaries With Medical Services | 4142 |
| Total Medical Submitted Charge Amount | 1251464 |
| Total Medical Medicare Allowed Amount | 269493.01 |
| Total Medical Medicare Payment Amount | 198125.87 |
| Total Medical Medicare Standardized Payment Amount | 185161.59 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 793 |
| Number Of Beneficiaries Age 65 to 74 | 1291 |
| Number Of Beneficiaries Age 75 to 84 | 1196 |
| Number Of Beneficiaries Age Greater 84 | 862 |
| Number Of Female Beneficiaries | 2334 |
| Number Of Male Beneficiaries | 1808 |
| Number Of Non Hispanic White Beneficiaries | 1729 |
| Number Of Black or African American Beneficiaries | 812 |
| Number Of AsianPacific Islander Beneficiaries | 634 |
| Number Of Hispanic Beneficiaries | 850 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1055 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 3087 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 37 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 21 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.7756 |