| National Provider Identifier [NPI]: | 1497758106 |
| Last Name Of The Provider | IDICULA |
| First Name Of The Provider | JOSEPH |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10065 CORTEZ BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | WEEKI WACHEE |
| Zip Code Of The Provider | 346136389 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 97 |
| Number Of Services | 44944 |
| Number Of Medicare Beneficiaries | 1191 |
| Total Submitted Charge Amount | 2158267.71 |
| Total Medicare Allowed Amount | 1024839.77 |
| Total Medicare Payment Amount | 772620.55 |
| Total Medicare Standardized Payment Amount | 789109.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 33924 |
| Number Of Medicare Beneficiaries With Drug Services | 400 |
| Total Drug Submitted ChargeAmount | 128848.71 |
| Total Drug Medicare AllowedAmount | 46222.25 |
| Total Drug Medicare PaymentAmount | 36166.21 |
| Total Drug Medicare Standardized Payment Amount | 36166.21 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 91 |
| Number Of Medical Services | 11020 |
| Number Of Medicare Beneficiaries With Medical Services | 1191 |
| Total Medical Submitted Charge Amount | 2029419 |
| Total Medical Medicare Allowed Amount | 978617.52 |
| Total Medical Medicare Payment Amount | 736454.34 |
| Total Medical Medicare Standardized Payment Amount | 752943.52 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 398 |
| Number Of Beneficiaries Age 75 to 84 | 471 |
| Number Of Beneficiaries Age Greater 84 | 276 |
| Number Of Female Beneficiaries | 585 |
| Number Of Male Beneficiaries | 606 |
| Number Of Non Hispanic White Beneficiaries | 1111 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 49 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1146 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 45 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 75 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.4352 |