| National Provider Identifier [NPI]: | 1235116831 |
| Last Name Of The Provider | SICKLES |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3705 OLENTANGY RIVER RD |
| Street Address 2 Of The Provider | #260 |
| City Of The Provider | COLUMBUS |
| Zip Code Of The Provider | 432143467 |
| 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 | 43 |
| Number Of Services | 553 |
| Number Of Medicare Beneficiaries | 110 |
| Total Submitted Charge Amount | 56781 |
| Total Medicare Allowed Amount | 29843.07 |
| Total Medicare Payment Amount | 20645.54 |
| Total Medicare Standardized Payment Amount | 21991.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 64 |
| Number Of Medicare Beneficiaries With Drug Services | 30 |
| Total Drug Submitted ChargeAmount | 4029 |
| Total Drug Medicare AllowedAmount | 1888.55 |
| Total Drug Medicare PaymentAmount | 1675.7 |
| Total Drug Medicare Standardized Payment Amount | 1675.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 37 |
| Number Of Medical Services | 489 |
| Number Of Medicare Beneficiaries With Medical Services | 110 |
| Total Medical Submitted Charge Amount | 52752 |
| Total Medical Medicare Allowed Amount | 27954.52 |
| Total Medical Medicare Payment Amount | 18969.84 |
| Total Medical Medicare Standardized Payment Amount | 20316.04 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 55 |
| Number Of Beneficiaries Age 75 to 84 | 29 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 48 |
| Number Of Male Beneficiaries | 62 |
| Number Of Non Hispanic White Beneficiaries | 98 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 99 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1528 |