| National Provider Identifier [NPI]: | 1285600510 |
| Last Name Of The Provider | DIMENT |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2322 S 57TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT SMITH |
| Zip Code Of The Provider | 729033813 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 272 |
| Number Of Services | 9115 |
| Number Of Medicare Beneficiaries | 4388 |
| Total Submitted Charge Amount | 933728 |
| Total Medicare Allowed Amount | 240392.09 |
| Total Medicare Payment Amount | 185180.4 |
| Total Medicare Standardized Payment Amount | 202020.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1790 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 2270 |
| Total Drug Medicare AllowedAmount | 387.88 |
| Total Drug Medicare PaymentAmount | 304.04 |
| Total Drug Medicare Standardized Payment Amount | 304.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 270 |
| Number Of Medical Services | 7325 |
| Number Of Medicare Beneficiaries With Medical Services | 4388 |
| Total Medical Submitted Charge Amount | 931458 |
| Total Medical Medicare Allowed Amount | 240004.21 |
| Total Medical Medicare Payment Amount | 184876.36 |
| Total Medical Medicare Standardized Payment Amount | 201716.34 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 893 |
| Number Of Beneficiaries Age 65 to 74 | 1629 |
| Number Of Beneficiaries Age 75 to 84 | 1266 |
| Number Of Beneficiaries Age Greater 84 | 600 |
| Number Of Female Beneficiaries | 2700 |
| Number Of Male Beneficiaries | 1688 |
| Number Of Non Hispanic White Beneficiaries | 4052 |
| Number Of Black or African American Beneficiaries | 88 |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | 135 |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3159 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1229 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 50 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4647 |