| National Provider Identifier [NPI]: | 1790872497 |
| Last Name Of The Provider | TICKNER |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 439 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HUDSON |
| Zip Code Of The Provider | 017491855 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 6101 |
| Number Of Medicare Beneficiaries | 1449 |
| Total Submitted Charge Amount | 574015 |
| Total Medicare Allowed Amount | 311086.44 |
| Total Medicare Payment Amount | 223344.06 |
| Total Medicare Standardized Payment Amount | 213089.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 47 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 514 |
| Total Drug Medicare AllowedAmount | 90.74 |
| Total Drug Medicare PaymentAmount | 71.18 |
| Total Drug Medicare Standardized Payment Amount | 71.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 6054 |
| Number Of Medicare Beneficiaries With Medical Services | 1449 |
| Total Medical Submitted Charge Amount | 573501 |
| Total Medical Medicare Allowed Amount | 310995.7 |
| Total Medical Medicare Payment Amount | 223272.88 |
| Total Medical Medicare Standardized Payment Amount | 213018.08 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 224 |
| Number Of Beneficiaries Age 65 to 74 | 258 |
| Number Of Beneficiaries Age 75 to 84 | 331 |
| Number Of Beneficiaries Age Greater 84 | 636 |
| Number Of Female Beneficiaries | 901 |
| Number Of Male Beneficiaries | 548 |
| Number Of Non Hispanic White Beneficiaries | 1370 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 38 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 654 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 795 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 50 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.7699 |