| National Provider Identifier [NPI]: | 1366424996 |
| Last Name Of The Provider | MEDLOCK |
| First Name Of The Provider | RICKEY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9800 LILE DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | LITTLE ROCK |
| Zip Code Of The Provider | 722056229 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 11856 |
| Number Of Medicare Beneficiaries | 1404 |
| Total Submitted Charge Amount | 4377331 |
| Total Medicare Allowed Amount | 1749047.98 |
| Total Medicare Payment Amount | 1321819.98 |
| Total Medicare Standardized Payment Amount | 1402078.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 2342 |
| Number Of Medicare Beneficiaries With Drug Services | 398 |
| Total Drug Submitted ChargeAmount | 1832366 |
| Total Drug Medicare AllowedAmount | 891779.61 |
| Total Drug Medicare PaymentAmount | 697116.31 |
| Total Drug Medicare Standardized Payment Amount | 697116.31 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 9514 |
| Number Of Medicare Beneficiaries With Medical Services | 1404 |
| Total Medical Submitted Charge Amount | 2544965 |
| Total Medical Medicare Allowed Amount | 857268.37 |
| Total Medical Medicare Payment Amount | 624703.67 |
| Total Medical Medicare Standardized Payment Amount | 704962.43 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 104 |
| Number Of Beneficiaries Age 65 to 74 | 436 |
| Number Of Beneficiaries Age 75 to 84 | 547 |
| Number Of Beneficiaries Age Greater 84 | 317 |
| Number Of Female Beneficiaries | 871 |
| Number Of Male Beneficiaries | 533 |
| Number Of Non Hispanic White Beneficiaries | 1331 |
| Number Of Black or African American Beneficiaries | 51 |
| 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 | 1216 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 188 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3344 |