| National Provider Identifier [NPI]: | 1336375500 |
| Last Name Of The Provider | DICKS |
| First Name Of The Provider | DEMETRIUS |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1959 NE PACIFIC ST |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY, NW011L |
| City Of The Provider | SEATTLE |
| Zip Code Of The Provider | 981950001 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 6059 |
| Number Of Medicare Beneficiaries | 3704 |
| Total Submitted Charge Amount | 697204 |
| Total Medicare Allowed Amount | 132458.89 |
| Total Medicare Payment Amount | 102295.14 |
| Total Medicare Standardized Payment Amount | 97826.84 |
| 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 | 92 |
| Number Of Medical Services | 6059 |
| Number Of Medicare Beneficiaries With Medical Services | 3704 |
| Total Medical Submitted Charge Amount | 697204 |
| Total Medical Medicare Allowed Amount | 132458.89 |
| Total Medical Medicare Payment Amount | 102295.14 |
| Total Medical Medicare Standardized Payment Amount | 97826.84 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 590 |
| Number Of Beneficiaries Age 65 to 74 | 1024 |
| Number Of Beneficiaries Age 75 to 84 | 1109 |
| Number Of Beneficiaries Age Greater 84 | 981 |
| Number Of Female Beneficiaries | 2024 |
| Number Of Male Beneficiaries | 1680 |
| Number Of Non Hispanic White Beneficiaries | 2954 |
| Number Of Black or African American Beneficiaries | 457 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 195 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 56 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2266 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1438 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 57 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.3518 |