| National Provider Identifier [NPI]: | 1043376189 |
| Last Name Of The Provider | HICKEY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2870 HEMPSTEAD TPKE STE 103 |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEVITTOWN |
| Zip Code Of The Provider | 117561341 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 5116 |
| Number Of Medicare Beneficiaries | 648 |
| Total Submitted Charge Amount | 298374.7 |
| Total Medicare Allowed Amount | 260795.82 |
| Total Medicare Payment Amount | 196995.38 |
| Total Medicare Standardized Payment Amount | 168891.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 89.2 |
| Total Drug Medicare AllowedAmount | 39.92 |
| Total Drug Medicare PaymentAmount | 31.34 |
| Total Drug Medicare Standardized Payment Amount | 31.34 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 5094 |
| Number Of Medicare Beneficiaries With Medical Services | 648 |
| Total Medical Submitted Charge Amount | 298285.5 |
| Total Medical Medicare Allowed Amount | 260755.9 |
| Total Medical Medicare Payment Amount | 196964.04 |
| Total Medical Medicare Standardized Payment Amount | 168860.12 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 188 |
| Number Of Beneficiaries Age 75 to 84 | 237 |
| Number Of Beneficiaries Age Greater 84 | 162 |
| Number Of Female Beneficiaries | 382 |
| Number Of Male Beneficiaries | 266 |
| Number Of Non Hispanic White Beneficiaries | 602 |
| Number Of Black or African American Beneficiaries | 15 |
| 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 | 584 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 64 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.4063 |