| National Provider Identifier [NPI]: | 1699987313 |
| Last Name Of The Provider | DIXON |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1508 WILLOW LAWN DR |
| Street Address 2 Of The Provider | STE 117 |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232303421 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 119 |
| Number Of Services | 7643 |
| Number Of Medicare Beneficiaries | 4781 |
| Total Submitted Charge Amount | 465449.99 |
| Total Medicare Allowed Amount | 177844.64 |
| Total Medicare Payment Amount | 141800.97 |
| Total Medicare Standardized Payment Amount | 146745.66 |
| 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 | 119 |
| Number Of Medical Services | 7643 |
| Number Of Medicare Beneficiaries With Medical Services | 4781 |
| Total Medical Submitted Charge Amount | 465449.99 |
| Total Medical Medicare Allowed Amount | 177844.64 |
| Total Medical Medicare Payment Amount | 141800.97 |
| Total Medical Medicare Standardized Payment Amount | 146745.66 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 632 |
| Number Of Beneficiaries Age 65 to 74 | 2017 |
| Number Of Beneficiaries Age 75 to 84 | 1393 |
| Number Of Beneficiaries Age Greater 84 | 739 |
| Number Of Female Beneficiaries | 3584 |
| Number Of Male Beneficiaries | 1197 |
| Number Of Non Hispanic White Beneficiaries | 3437 |
| Number Of Black or African American Beneficiaries | 1208 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 43 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3966 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 815 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4158 |