| National Provider Identifier [NPI]: | 1659586360 |
| Last Name Of The Provider | TSALIKOVA |
| First Name Of The Provider | FATIMA |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 291 W SCHROCK RD |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | WESTERVILLE |
| Zip Code Of The Provider | 430812895 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 135 |
| Number Of Services | 2754 |
| Number Of Medicare Beneficiaries | 140 |
| Total Submitted Charge Amount | 121989 |
| Total Medicare Allowed Amount | 68736.96 |
| Total Medicare Payment Amount | 54910.98 |
| Total Medicare Standardized Payment Amount | 57459.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 848 |
| Number Of Medicare Beneficiaries With Drug Services | 65 |
| Total Drug Submitted ChargeAmount | 4791 |
| Total Drug Medicare AllowedAmount | 3078.31 |
| Total Drug Medicare PaymentAmount | 2941.02 |
| Total Drug Medicare Standardized Payment Amount | 2941.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 122 |
| Number Of Medical Services | 1906 |
| Number Of Medicare Beneficiaries With Medical Services | 140 |
| Total Medical Submitted Charge Amount | 117198 |
| Total Medical Medicare Allowed Amount | 65658.65 |
| Total Medical Medicare Payment Amount | 51969.96 |
| Total Medical Medicare Standardized Payment Amount | 54518.71 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 71 |
| Number Of Beneficiaries Age 75 to 84 | 35 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 106 |
| Number Of Male Beneficiaries | 34 |
| Number Of Non Hispanic White Beneficiaries | 127 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8563 |