| National Provider Identifier [NPI]: | 1245264308 |
| Last Name Of The Provider | HICKS |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 759 CHESTNUT ST |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| City Of The Provider | SPRINGFIELD |
| Zip Code Of The Provider | 011071619 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 122 |
| Number Of Services | 1918 |
| Number Of Medicare Beneficiaries | 1379 |
| Total Submitted Charge Amount | 329705 |
| Total Medicare Allowed Amount | 102546.51 |
| Total Medicare Payment Amount | 76129.52 |
| Total Medicare Standardized Payment Amount | 76301.74 |
| 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 | 122 |
| Number Of Medical Services | 1918 |
| Number Of Medicare Beneficiaries With Medical Services | 1379 |
| Total Medical Submitted Charge Amount | 329705 |
| Total Medical Medicare Allowed Amount | 102546.51 |
| Total Medical Medicare Payment Amount | 76129.52 |
| Total Medical Medicare Standardized Payment Amount | 76301.74 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 313 |
| Number Of Beneficiaries Age 65 to 74 | 468 |
| Number Of Beneficiaries Age 75 to 84 | 360 |
| Number Of Beneficiaries Age Greater 84 | 238 |
| Number Of Female Beneficiaries | 732 |
| Number Of Male Beneficiaries | 647 |
| Number Of Non Hispanic White Beneficiaries | 1104 |
| Number Of Black or African American Beneficiaries | 101 |
| Number Of AsianPacific Islander Beneficiaries | 14 |
| Number Of Hispanic Beneficiaries | 145 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 784 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 595 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 2.0731 |