| National Provider Identifier [NPI]: | 1821249301 |
| Last Name Of The Provider | DICICCO |
| First Name Of The Provider | SHARON |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1532 LONE OAK RD |
| Street Address 2 Of The Provider | SUITE 245 |
| City Of The Provider | PADUCAH |
| Zip Code Of The Provider | 420037941 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 532 |
| Number Of Medicare Beneficiaries | 437 |
| Total Submitted Charge Amount | 64914 |
| Total Medicare Allowed Amount | 33649.54 |
| Total Medicare Payment Amount | 21764.92 |
| Total Medicare Standardized Payment Amount | 29263.9 |
| 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 | 8 |
| Number Of Medical Services | 532 |
| Number Of Medicare Beneficiaries With Medical Services | 437 |
| Total Medical Submitted Charge Amount | 64914 |
| Total Medical Medicare Allowed Amount | 33649.54 |
| Total Medical Medicare Payment Amount | 21764.92 |
| Total Medical Medicare Standardized Payment Amount | 29263.9 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 117 |
| Number Of Beneficiaries Age 65 to 74 | 190 |
| Number Of Beneficiaries Age 75 to 84 | 107 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 320 |
| Number Of Male Beneficiaries | 117 |
| Number Of Non Hispanic White Beneficiaries | 400 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 325 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 112 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3111 |