| National Provider Identifier [NPI]: | 1558685206 |
| Last Name Of The Provider | CHIRICA |
| First Name Of The Provider | FLORENTINA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2815 DUSTIN RD |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | OREGON |
| Zip Code Of The Provider | 436163495 |
| 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 | 31 |
| Number Of Services | 285 |
| Number Of Medicare Beneficiaries | 72 |
| Total Submitted Charge Amount | 36596 |
| Total Medicare Allowed Amount | 24236.91 |
| Total Medicare Payment Amount | 18415.2 |
| Total Medicare Standardized Payment Amount | 18909.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 24 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 820 |
| Total Drug Medicare AllowedAmount | 350.26 |
| Total Drug Medicare PaymentAmount | 337.91 |
| Total Drug Medicare Standardized Payment Amount | 337.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 261 |
| Number Of Medicare Beneficiaries With Medical Services | 72 |
| Total Medical Submitted Charge Amount | 35776 |
| Total Medical Medicare Allowed Amount | 23886.65 |
| Total Medical Medicare Payment Amount | 18077.29 |
| Total Medical Medicare Standardized Payment Amount | 18571.47 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 18 |
| Number Of Beneficiaries Age 75 to 84 | 17 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 46 |
| Number Of Male Beneficiaries | 26 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 45 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 27 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.5808 |