| National Provider Identifier [NPI]: | 1588640148 |
| Last Name Of The Provider | DICKERSON |
| First Name Of The Provider | CRISTIN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2020 ALBANS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770051643 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 108 |
| Number Of Services | 19557 |
| Number Of Medicare Beneficiaries | 2653 |
| Total Submitted Charge Amount | 391434.12 |
| Total Medicare Allowed Amount | 385574.6 |
| Total Medicare Payment Amount | 307054.94 |
| Total Medicare Standardized Payment Amount | 307014.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 14800 |
| Number Of Medicare Beneficiaries With Drug Services | 173 |
| Total Drug Submitted ChargeAmount | 6078.1 |
| Total Drug Medicare AllowedAmount | 4558.51 |
| Total Drug Medicare PaymentAmount | 3367.37 |
| Total Drug Medicare Standardized Payment Amount | 3367.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 105 |
| Number Of Medical Services | 4757 |
| Number Of Medicare Beneficiaries With Medical Services | 2653 |
| Total Medical Submitted Charge Amount | 385356.02 |
| Total Medical Medicare Allowed Amount | 381016.09 |
| Total Medical Medicare Payment Amount | 303687.57 |
| Total Medical Medicare Standardized Payment Amount | 303647.48 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 76 |
| Number Of Beneficiaries Age 65 to 74 | 1228 |
| Number Of Beneficiaries Age 75 to 84 | 961 |
| Number Of Beneficiaries Age Greater 84 | 388 |
| Number Of Female Beneficiaries | 1901 |
| Number Of Male Beneficiaries | 752 |
| Number Of Non Hispanic White Beneficiaries | 2274 |
| Number Of Black or African American Beneficiaries | 183 |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 110 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2575 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 78 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.885 |