| National Provider Identifier [NPI]: | 1699715300 |
| Last Name Of The Provider | SICILIANO |
| First Name Of The Provider | DEAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 90 JACKSON PIKE |
| Street Address 2 Of The Provider | |
| City Of The Provider | GALLIPOLIS |
| Zip Code Of The Provider | 456311560 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 258 |
| Number Of Services | 4623 |
| Number Of Medicare Beneficiaries | 2571 |
| Total Submitted Charge Amount | 1183747 |
| Total Medicare Allowed Amount | 152950.54 |
| Total Medicare Payment Amount | 113731.81 |
| Total Medicare Standardized Payment Amount | 117684.58 |
| 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 | 258 |
| Number Of Medical Services | 4623 |
| Number Of Medicare Beneficiaries With Medical Services | 2571 |
| Total Medical Submitted Charge Amount | 1183747 |
| Total Medical Medicare Allowed Amount | 152950.54 |
| Total Medical Medicare Payment Amount | 113731.81 |
| Total Medical Medicare Standardized Payment Amount | 117684.58 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 702 |
| Number Of Beneficiaries Age 65 to 74 | 886 |
| Number Of Beneficiaries Age 75 to 84 | 705 |
| Number Of Beneficiaries Age Greater 84 | 278 |
| Number Of Female Beneficiaries | 1682 |
| Number Of Male Beneficiaries | 889 |
| Number Of Non Hispanic White Beneficiaries | 2498 |
| Number Of Black or African American Beneficiaries | 41 |
| 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 | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1545 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1026 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 36 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5048 |