| National Provider Identifier [NPI]: | 1932148020 |
| Last Name Of The Provider | DICKASON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 790 BOSTON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BILLERICA |
| Zip Code Of The Provider | 018215938 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 82 |
| Number Of Services | 1142 |
| Number Of Medicare Beneficiaries | 197 |
| Total Submitted Charge Amount | 96619 |
| Total Medicare Allowed Amount | 59732.53 |
| Total Medicare Payment Amount | 44714.47 |
| Total Medicare Standardized Payment Amount | 42841.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 39 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 2015 |
| Total Drug Medicare AllowedAmount | 1340.16 |
| Total Drug Medicare PaymentAmount | 1308.24 |
| Total Drug Medicare Standardized Payment Amount | 1308.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 1103 |
| Number Of Medicare Beneficiaries With Medical Services | 197 |
| Total Medical Submitted Charge Amount | 94604 |
| Total Medical Medicare Allowed Amount | 58392.37 |
| Total Medical Medicare Payment Amount | 43406.23 |
| Total Medical Medicare Standardized Payment Amount | 41533.49 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 25 |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | 61 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 122 |
| Number Of Male Beneficiaries | 75 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 153 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5901 |