| National Provider Identifier [NPI]: | 1447366174 |
| Last Name Of The Provider | FATICA |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9500 EUCLID AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CLEVELAND |
| Zip Code Of The Provider | 441950001 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 804 |
| Number Of Medicare Beneficiaries | 344 |
| Total Submitted Charge Amount | 365732 |
| Total Medicare Allowed Amount | 80347.78 |
| Total Medicare Payment Amount | 61054.78 |
| Total Medicare Standardized Payment Amount | 62309.09 |
| 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 | 26 |
| Number Of Medical Services | 804 |
| Number Of Medicare Beneficiaries With Medical Services | 344 |
| Total Medical Submitted Charge Amount | 365732 |
| Total Medical Medicare Allowed Amount | 80347.78 |
| Total Medical Medicare Payment Amount | 61054.78 |
| Total Medical Medicare Standardized Payment Amount | 62309.09 |
| Average Age Of Beneficiaries | 58 |
| Number Of Beneficiaries Age Less65 | 202 |
| Number Of Beneficiaries Age 65 to 74 | 113 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 123 |
| Number Of Male Beneficiaries | 221 |
| Number Of Non Hispanic White Beneficiaries | 241 |
| Number Of Black or African American Beneficiaries | 71 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 234 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 110 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 4.3363 |