| National Provider Identifier [NPI]: | 1285722082 |
| Last Name Of The Provider | DEKICH |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 121 N 20TH ST |
| Street Address 2 Of The Provider | #6 |
| City Of The Provider | OPELIKA |
| Zip Code Of The Provider | 368015449 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 4118 |
| Number Of Medicare Beneficiaries | 859 |
| Total Submitted Charge Amount | 368500.5 |
| Total Medicare Allowed Amount | 258223.95 |
| Total Medicare Payment Amount | 193932.29 |
| Total Medicare Standardized Payment Amount | 183773.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 680 |
| Number Of Medicare Beneficiaries With Drug Services | 103 |
| Total Drug Submitted ChargeAmount | 5280.5 |
| Total Drug Medicare AllowedAmount | 2711.13 |
| Total Drug Medicare PaymentAmount | 2417.3 |
| Total Drug Medicare Standardized Payment Amount | 2417.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 3438 |
| Number Of Medicare Beneficiaries With Medical Services | 859 |
| Total Medical Submitted Charge Amount | 363220 |
| Total Medical Medicare Allowed Amount | 255512.82 |
| Total Medical Medicare Payment Amount | 191514.99 |
| Total Medical Medicare Standardized Payment Amount | 181356.3 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 198 |
| Number Of Beneficiaries Age 65 to 74 | 368 |
| Number Of Beneficiaries Age 75 to 84 | 223 |
| Number Of Beneficiaries Age Greater 84 | 70 |
| Number Of Female Beneficiaries | 459 |
| Number Of Male Beneficiaries | 400 |
| Number Of Non Hispanic White Beneficiaries | 624 |
| Number Of Black or African American Beneficiaries | 224 |
| 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 | 681 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 178 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 44 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.6545 |