| National Provider Identifier [NPI]: | 1033137666 |
| Last Name Of The Provider | VICK |
| First Name Of The Provider | JOHN |
| 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 | 1106 REYNOLDS ST |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | MONROE |
| Zip Code Of The Provider | 281124375 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 4313.5 |
| Number Of Medicare Beneficiaries | 540 |
| Total Submitted Charge Amount | 470815.5 |
| Total Medicare Allowed Amount | 209676.26 |
| Total Medicare Payment Amount | 145949.3 |
| Total Medicare Standardized Payment Amount | 152519.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 614.5 |
| Number Of Medicare Beneficiaries With Drug Services | 223 |
| Total Drug Submitted ChargeAmount | 34601.5 |
| Total Drug Medicare AllowedAmount | 10969.82 |
| Total Drug Medicare PaymentAmount | 9847.91 |
| Total Drug Medicare Standardized Payment Amount | 9847.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 3699 |
| Number Of Medicare Beneficiaries With Medical Services | 539 |
| Total Medical Submitted Charge Amount | 436214 |
| Total Medical Medicare Allowed Amount | 198706.44 |
| Total Medical Medicare Payment Amount | 136101.39 |
| Total Medical Medicare Standardized Payment Amount | 142671.19 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 204 |
| Number Of Beneficiaries Age 75 to 84 | 199 |
| Number Of Beneficiaries Age Greater 84 | 89 |
| Number Of Female Beneficiaries | 311 |
| Number Of Male Beneficiaries | 229 |
| Number Of Non Hispanic White Beneficiaries | 488 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 471 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1271 |