| National Provider Identifier [NPI]: | 1033201587 |
| Last Name Of The Provider | NICHOLS |
| First Name Of The Provider | GARY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3883 AIRWAY DR |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | SANTA ROSA |
| Zip Code Of The Provider | 954031670 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 4188 |
| Number Of Medicare Beneficiaries | 552 |
| Total Submitted Charge Amount | 751579 |
| Total Medicare Allowed Amount | 294726.95 |
| Total Medicare Payment Amount | 211423.17 |
| Total Medicare Standardized Payment Amount | 204738.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 1232 |
| Number Of Medicare Beneficiaries With Drug Services | 245 |
| Total Drug Submitted ChargeAmount | 48595 |
| Total Drug Medicare AllowedAmount | 23767.34 |
| Total Drug Medicare PaymentAmount | 21023.53 |
| Total Drug Medicare Standardized Payment Amount | 21023.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 2956 |
| Number Of Medicare Beneficiaries With Medical Services | 552 |
| Total Medical Submitted Charge Amount | 702984 |
| Total Medical Medicare Allowed Amount | 270959.61 |
| Total Medical Medicare Payment Amount | 190399.64 |
| Total Medical Medicare Standardized Payment Amount | 183714.61 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 56 |
| Number Of Beneficiaries Age 65 to 74 | 240 |
| Number Of Beneficiaries Age 75 to 84 | 163 |
| Number Of Beneficiaries Age Greater 84 | 93 |
| Number Of Female Beneficiaries | 329 |
| Number Of Male Beneficiaries | 223 |
| Number Of Non Hispanic White Beneficiaries | 493 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 492 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 60 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1214 |