| National Provider Identifier [NPI]: | 1053386136 |
| Last Name Of The Provider | EICKLER |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 44 N MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BAXLEY |
| Zip Code Of The Provider | 31515 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 191 |
| Number Of Services | 4548 |
| Number Of Medicare Beneficiaries | 3010 |
| Total Submitted Charge Amount | 762976 |
| Total Medicare Allowed Amount | 139697.04 |
| Total Medicare Payment Amount | 110798.33 |
| Total Medicare Standardized Payment Amount | 116399.42 |
| 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 | 191 |
| Number Of Medical Services | 4548 |
| Number Of Medicare Beneficiaries With Medical Services | 3010 |
| Total Medical Submitted Charge Amount | 762976 |
| Total Medical Medicare Allowed Amount | 139697.04 |
| Total Medical Medicare Payment Amount | 110798.33 |
| Total Medical Medicare Standardized Payment Amount | 116399.42 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 676 |
| Number Of Beneficiaries Age 65 to 74 | 1061 |
| Number Of Beneficiaries Age 75 to 84 | 864 |
| Number Of Beneficiaries Age Greater 84 | 409 |
| Number Of Female Beneficiaries | 1939 |
| Number Of Male Beneficiaries | 1071 |
| Number Of Non Hispanic White Beneficiaries | 2386 |
| Number Of Black or African American Beneficiaries | 592 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1815 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1195 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5732 |