| National Provider Identifier [NPI]: | 1508893504 |
| Last Name Of The Provider | WIXSON |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2125 OAK GROVE RD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | WALNUT CREEK |
| Zip Code Of The Provider | 945982536 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 136 |
| Number Of Services | 12918 |
| Number Of Medicare Beneficiaries | 2077 |
| Total Submitted Charge Amount | 686240 |
| Total Medicare Allowed Amount | 141732.15 |
| Total Medicare Payment Amount | 108617.76 |
| Total Medicare Standardized Payment Amount | 96427.59 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 10125 |
| Number Of Medicare Beneficiaries With Drug Services | 92 |
| Total Drug Submitted ChargeAmount | 10365 |
| Total Drug Medicare AllowedAmount | 2027.01 |
| Total Drug Medicare PaymentAmount | 1589.09 |
| Total Drug Medicare Standardized Payment Amount | 1589.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 133 |
| Number Of Medical Services | 2793 |
| Number Of Medicare Beneficiaries With Medical Services | 2077 |
| Total Medical Submitted Charge Amount | 675875 |
| Total Medical Medicare Allowed Amount | 139705.14 |
| Total Medical Medicare Payment Amount | 107028.67 |
| Total Medical Medicare Standardized Payment Amount | 94838.5 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 261 |
| Number Of Beneficiaries Age 65 to 74 | 706 |
| Number Of Beneficiaries Age 75 to 84 | 631 |
| Number Of Beneficiaries Age Greater 84 | 479 |
| Number Of Female Beneficiaries | 1191 |
| Number Of Male Beneficiaries | 886 |
| Number Of Non Hispanic White Beneficiaries | 1624 |
| Number Of Black or African American Beneficiaries | 117 |
| Number Of AsianPacific Islander Beneficiaries | 143 |
| 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 | 1605 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 472 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.8941 |