| National Provider Identifier [NPI]: | 1003900457 |
| Last Name Of The Provider | ROBISON |
| First Name Of The Provider | DIXON |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 24 E. BROADWAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | BUTTE |
| Zip Code Of The Provider | 59701 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 72 |
| Number Of Services | 8846 |
| Number Of Medicare Beneficiaries | 1519 |
| Total Submitted Charge Amount | 865972 |
| Total Medicare Allowed Amount | 412552.88 |
| Total Medicare Payment Amount | 283976.54 |
| Total Medicare Standardized Payment Amount | 279640.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 75 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 635 |
| Total Drug Medicare AllowedAmount | 172.67 |
| Total Drug Medicare PaymentAmount | 120.94 |
| Total Drug Medicare Standardized Payment Amount | 120.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 70 |
| Number Of Medical Services | 8771 |
| Number Of Medicare Beneficiaries With Medical Services | 1519 |
| Total Medical Submitted Charge Amount | 865337 |
| Total Medical Medicare Allowed Amount | 412380.21 |
| Total Medical Medicare Payment Amount | 283855.6 |
| Total Medical Medicare Standardized Payment Amount | 279519.58 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 664 |
| Number Of Beneficiaries Age 75 to 84 | 539 |
| Number Of Beneficiaries Age Greater 84 | 217 |
| Number Of Female Beneficiaries | 771 |
| Number Of Male Beneficiaries | 748 |
| Number Of Non Hispanic White Beneficiaries | 1487 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1380 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 139 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 38 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 0.9414 |