| National Provider Identifier [NPI]: | 1225003494 |
| Last Name Of The Provider | DEDIC |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4700 LAS VEGAS BLVD N |
| Street Address 2 Of The Provider | |
| City Of The Provider | NELLIS AFB |
| Zip Code Of The Provider | 891916600 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 147 |
| Number Of Services | 4386 |
| Number Of Medicare Beneficiaries | 2907 |
| Total Submitted Charge Amount | 413752 |
| Total Medicare Allowed Amount | 122035.47 |
| Total Medicare Payment Amount | 88687.78 |
| Total Medicare Standardized Payment Amount | 87560.98 |
| 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 | 147 |
| Number Of Medical Services | 4386 |
| Number Of Medicare Beneficiaries With Medical Services | 2907 |
| Total Medical Submitted Charge Amount | 413752 |
| Total Medical Medicare Allowed Amount | 122035.47 |
| Total Medical Medicare Payment Amount | 88687.78 |
| Total Medical Medicare Standardized Payment Amount | 87560.98 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 590 |
| Number Of Beneficiaries Age 65 to 74 | 1096 |
| Number Of Beneficiaries Age 75 to 84 | 805 |
| Number Of Beneficiaries Age Greater 84 | 416 |
| Number Of Female Beneficiaries | 1792 |
| Number Of Male Beneficiaries | 1115 |
| Number Of Non Hispanic White Beneficiaries | 1411 |
| Number Of Black or African American Beneficiaries | 90 |
| Number Of AsianPacific Islander Beneficiaries | 108 |
| Number Of Hispanic Beneficiaries | 1258 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1301 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1606 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6032 |