| National Provider Identifier [NPI]: | 1801839444 |
| Last Name Of The Provider | DICKERSON |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 W BROADWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | COUNCIL BLUFFS |
| Zip Code Of The Provider | 515039045 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 12 |
| Number Of Services | 2708 |
| Number Of Medicare Beneficiaries | 193 |
| Total Submitted Charge Amount | 242810 |
| Total Medicare Allowed Amount | 105603.88 |
| Total Medicare Payment Amount | 75363.62 |
| Total Medicare Standardized Payment Amount | 94722.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 411 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 11135 |
| Total Drug Medicare AllowedAmount | 5235.67 |
| Total Drug Medicare PaymentAmount | 3995.11 |
| Total Drug Medicare Standardized Payment Amount | 3995.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 2297 |
| Number Of Medicare Beneficiaries With Medical Services | 193 |
| Total Medical Submitted Charge Amount | 231675 |
| Total Medical Medicare Allowed Amount | 100368.21 |
| Total Medical Medicare Payment Amount | 71368.51 |
| Total Medical Medicare Standardized Payment Amount | 90727.45 |
| Average Age Of Beneficiaries | 50 |
| Number Of Beneficiaries Age Less65 | 164 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 90 |
| Number Of Male Beneficiaries | 103 |
| Number Of Non Hispanic White Beneficiaries | 154 |
| Number Of Black or African American Beneficiaries | 24 |
| 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 | 45 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 148 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 64 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 23 |
| Percent Of With Hypertension | 26 |
| Percent Of With Ischemic Heart Disease | 9 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 40 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1512 |