| National Provider Identifier [NPI]: | 1033136932 |
| Last Name Of The Provider | ICHINO |
| First Name Of The Provider | JAKE |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 E 2ND ST |
| Street Address 2 Of The Provider | SUITE 400 |
| City Of The Provider | RENO |
| Zip Code Of The Provider | 895021262 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 3104 |
| Number Of Medicare Beneficiaries | 1786 |
| Total Submitted Charge Amount | 811492 |
| Total Medicare Allowed Amount | 238315.71 |
| Total Medicare Payment Amount | 178386.17 |
| Total Medicare Standardized Payment Amount | 175763.59 |
| 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 | 54 |
| Number Of Medical Services | 3104 |
| Number Of Medicare Beneficiaries With Medical Services | 1786 |
| Total Medical Submitted Charge Amount | 811492 |
| Total Medical Medicare Allowed Amount | 238315.71 |
| Total Medical Medicare Payment Amount | 178386.17 |
| Total Medical Medicare Standardized Payment Amount | 175763.59 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 217 |
| Number Of Beneficiaries Age 65 to 74 | 825 |
| Number Of Beneficiaries Age 75 to 84 | 530 |
| Number Of Beneficiaries Age Greater 84 | 214 |
| Number Of Female Beneficiaries | 827 |
| Number Of Male Beneficiaries | 959 |
| Number Of Non Hispanic White Beneficiaries | 1556 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 96 |
| Number Of American Indian Alaska Native Beneficiaries | 37 |
| Number Of Beneficiaries With Race Not Else where Classified | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1476 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 310 |
| Percent Of With Atrial Fibrillation | 29 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5742 |