| National Provider Identifier [NPI]: | 1255304150 |
| Last Name Of The Provider | DICKERSON |
| First Name Of The Provider | SHELBY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1906 BELLEVIEW AVE SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROANOKE |
| Zip Code Of The Provider | 240141838 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 22441 |
| Number Of Medicare Beneficiaries | 12365 |
| Total Submitted Charge Amount | 564828 |
| Total Medicare Allowed Amount | 215614.85 |
| Total Medicare Payment Amount | 158196.15 |
| Total Medicare Standardized Payment Amount | 162088.62 |
| 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 | 10 |
| Number Of Medical Services | 22441 |
| Number Of Medicare Beneficiaries With Medical Services | 12365 |
| Total Medical Submitted Charge Amount | 564828 |
| Total Medical Medicare Allowed Amount | 215614.85 |
| Total Medical Medicare Payment Amount | 158196.15 |
| Total Medical Medicare Standardized Payment Amount | 162088.62 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 2443 |
| Number Of Beneficiaries Age 65 to 74 | 4666 |
| Number Of Beneficiaries Age 75 to 84 | 3423 |
| Number Of Beneficiaries Age Greater 84 | 1833 |
| Number Of Female Beneficiaries | 6790 |
| Number Of Male Beneficiaries | 5575 |
| Number Of Non Hispanic White Beneficiaries | 10952 |
| Number Of Black or African American Beneficiaries | 1191 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 79 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 101 |
| Number Of Beneficiaries With Medicare Only Entitlement | 9285 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 3080 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5821 |