| National Provider Identifier [NPI]: | 1164418158 |
| Last Name Of The Provider | DICKER |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 AINSWORTH DR |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | PRESCOTT |
| Zip Code Of The Provider | 863051667 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 293 |
| Number Of Services | 24901 |
| Number Of Medicare Beneficiaries | 4947 |
| Total Submitted Charge Amount | 2029169.8 |
| Total Medicare Allowed Amount | 540315.46 |
| Total Medicare Payment Amount | 409062.47 |
| Total Medicare Standardized Payment Amount | 415212.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 15804 |
| Number Of Medicare Beneficiaries With Drug Services | 202 |
| Total Drug Submitted ChargeAmount | 15878.8 |
| Total Drug Medicare AllowedAmount | 3808.11 |
| Total Drug Medicare PaymentAmount | 2775.49 |
| Total Drug Medicare Standardized Payment Amount | 2775.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 291 |
| Number Of Medical Services | 9097 |
| Number Of Medicare Beneficiaries With Medical Services | 4947 |
| Total Medical Submitted Charge Amount | 2013291 |
| Total Medical Medicare Allowed Amount | 536507.35 |
| Total Medical Medicare Payment Amount | 406286.98 |
| Total Medical Medicare Standardized Payment Amount | 412436.74 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 396 |
| Number Of Beneficiaries Age 65 to 74 | 2124 |
| Number Of Beneficiaries Age 75 to 84 | 1649 |
| Number Of Beneficiaries Age Greater 84 | 778 |
| Number Of Female Beneficiaries | 2878 |
| Number Of Male Beneficiaries | 2069 |
| Number Of Non Hispanic White Beneficiaries | 4657 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | 40 |
| Number Of Hispanic Beneficiaries | 165 |
| Number Of American Indian Alaska Native Beneficiaries | 21 |
| Number Of Beneficiaries With Race Not Else where Classified | 45 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4440 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 507 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.278 |