| National Provider Identifier [NPI]: | 1043200587 |
| Last Name Of The Provider | HICKMAN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3633 CENTRAL AVENUE |
| Street Address 2 Of The Provider | SUITE D |
| City Of The Provider | HOT SPRINGS |
| Zip Code Of The Provider | 719136475 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 277 |
| Number Of Services | 3609 |
| Number Of Medicare Beneficiaries | 1808 |
| Total Submitted Charge Amount | 703782 |
| Total Medicare Allowed Amount | 178719.39 |
| Total Medicare Payment Amount | 140001.36 |
| Total Medicare Standardized Payment Amount | 151530.16 |
| 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 | 277 |
| Number Of Medical Services | 3609 |
| Number Of Medicare Beneficiaries With Medical Services | 1808 |
| Total Medical Submitted Charge Amount | 703782 |
| Total Medical Medicare Allowed Amount | 178719.39 |
| Total Medical Medicare Payment Amount | 140001.36 |
| Total Medical Medicare Standardized Payment Amount | 151530.16 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 252 |
| Number Of Beneficiaries Age 65 to 74 | 766 |
| Number Of Beneficiaries Age 75 to 84 | 588 |
| Number Of Beneficiaries Age Greater 84 | 202 |
| Number Of Female Beneficiaries | 1191 |
| Number Of Male Beneficiaries | 617 |
| Number Of Non Hispanic White Beneficiaries | 1677 |
| Number Of Black or African American Beneficiaries | 104 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1473 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 335 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.6713 |