| National Provider Identifier [NPI]: | 1760428569 |
| Last Name Of The Provider | VICKERS |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5000 W 4TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HATTIESBURG |
| Zip Code Of The Provider | 394021000 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 278 |
| Number Of Services | 21658 |
| Number Of Medicare Beneficiaries | 5950 |
| Total Submitted Charge Amount | 1574558 |
| Total Medicare Allowed Amount | 329872.39 |
| Total Medicare Payment Amount | 249379.28 |
| Total Medicare Standardized Payment Amount | 273878.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 12211 |
| Number Of Medicare Beneficiaries With Drug Services | 165 |
| Total Drug Submitted ChargeAmount | 14414 |
| Total Drug Medicare AllowedAmount | 3247.61 |
| Total Drug Medicare PaymentAmount | 2546.28 |
| Total Drug Medicare Standardized Payment Amount | 2546.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 275 |
| Number Of Medical Services | 9447 |
| Number Of Medicare Beneficiaries With Medical Services | 5950 |
| Total Medical Submitted Charge Amount | 1560144 |
| Total Medical Medicare Allowed Amount | 326624.78 |
| Total Medical Medicare Payment Amount | 246833 |
| Total Medical Medicare Standardized Payment Amount | 271332.55 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1391 |
| Number Of Beneficiaries Age 65 to 74 | 2124 |
| Number Of Beneficiaries Age 75 to 84 | 1640 |
| Number Of Beneficiaries Age Greater 84 | 795 |
| Number Of Female Beneficiaries | 3504 |
| Number Of Male Beneficiaries | 2446 |
| Number Of Non Hispanic White Beneficiaries | 4495 |
| Number Of Black or African American Beneficiaries | 1392 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3585 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2365 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.703 |