| National Provider Identifier [NPI]: | 1215234745 |
| Last Name Of The Provider | HICKNER |
| First Name Of The Provider | ZACHARY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1906 W MILHAM AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORTAGE |
| Zip Code Of The Provider | 490241232 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 2009 |
| Number Of Medicare Beneficiaries | 1008 |
| Total Submitted Charge Amount | 680135 |
| Total Medicare Allowed Amount | 322947.33 |
| Total Medicare Payment Amount | 227615.46 |
| Total Medicare Standardized Payment Amount | 242832.42 |
| 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 | 34 |
| Number Of Medical Services | 2009 |
| Number Of Medicare Beneficiaries With Medical Services | 1008 |
| Total Medical Submitted Charge Amount | 680135 |
| Total Medical Medicare Allowed Amount | 322947.33 |
| Total Medical Medicare Payment Amount | 227615.46 |
| Total Medical Medicare Standardized Payment Amount | 242832.42 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 377 |
| Number Of Beneficiaries Age 75 to 84 | 350 |
| Number Of Beneficiaries Age Greater 84 | 220 |
| Number Of Female Beneficiaries | 610 |
| Number Of Male Beneficiaries | 398 |
| Number Of Non Hispanic White Beneficiaries | 952 |
| Number Of Black or African American Beneficiaries | 34 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 939 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0487 |