| National Provider Identifier [NPI]: | 1164463311 |
| Last Name Of The Provider | ICHTER |
| First Name Of The Provider | JON |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 16A MANOR AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MILLERSVILLE |
| Zip Code Of The Provider | 175511123 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 2116 |
| Number Of Medicare Beneficiaries | 338 |
| Total Submitted Charge Amount | 148480 |
| Total Medicare Allowed Amount | 90255.65 |
| Total Medicare Payment Amount | 69977.18 |
| Total Medicare Standardized Payment Amount | 72651.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 161 |
| Number Of Medicare Beneficiaries With Drug Services | 112 |
| Total Drug Submitted ChargeAmount | 12027 |
| Total Drug Medicare AllowedAmount | 7992.61 |
| Total Drug Medicare PaymentAmount | 7812.45 |
| Total Drug Medicare Standardized Payment Amount | 7812.45 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 1955 |
| Number Of Medicare Beneficiaries With Medical Services | 338 |
| Total Medical Submitted Charge Amount | 136453 |
| Total Medical Medicare Allowed Amount | 82263.04 |
| Total Medical Medicare Payment Amount | 62164.73 |
| Total Medical Medicare Standardized Payment Amount | 64838.6 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 157 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 58 |
| Number Of Female Beneficiaries | 180 |
| Number Of Male Beneficiaries | 158 |
| Number Of Non Hispanic White Beneficiaries | 325 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 326 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 12 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.0077 |