| National Provider Identifier [NPI]: | 1942287735 |
| Last Name Of The Provider | DICKINSON |
| First Name Of The Provider | BRETT |
| 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 | 1105 W LIBERTY ST |
| Street Address 2 Of The Provider | SUITE 4020 |
| City Of The Provider | FARMINGTON |
| Zip Code Of The Provider | 636401921 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 3816 |
| Number Of Medicare Beneficiaries | 631 |
| Total Submitted Charge Amount | 667875.04 |
| Total Medicare Allowed Amount | 192102.88 |
| Total Medicare Payment Amount | 141341.53 |
| Total Medicare Standardized Payment Amount | 151872.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 477 |
| Number Of Medicare Beneficiaries With Drug Services | 177 |
| Total Drug Submitted ChargeAmount | 34820 |
| Total Drug Medicare AllowedAmount | 11432.83 |
| Total Drug Medicare PaymentAmount | 10549.72 |
| Total Drug Medicare Standardized Payment Amount | 10549.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 3339 |
| Number Of Medicare Beneficiaries With Medical Services | 631 |
| Total Medical Submitted Charge Amount | 633055.04 |
| Total Medical Medicare Allowed Amount | 180670.05 |
| Total Medical Medicare Payment Amount | 130791.81 |
| Total Medical Medicare Standardized Payment Amount | 141322.8 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 158 |
| Number Of Beneficiaries Age 65 to 74 | 229 |
| Number Of Beneficiaries Age 75 to 84 | 183 |
| Number Of Beneficiaries Age Greater 84 | 61 |
| Number Of Female Beneficiaries | 338 |
| Number Of Male Beneficiaries | 293 |
| Number Of Non Hispanic White Beneficiaries | 616 |
| 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 | 490 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 141 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2715 |