| National Provider Identifier [NPI]: | 1174583785 |
| Last Name Of The Provider | GUICHO |
| First Name Of The Provider | KATHLEEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | NP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2 ESSEX CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | PEABODY |
| Zip Code Of The Provider | 019602902 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 75 |
| Number Of Services | 1044 |
| Number Of Medicare Beneficiaries | 238 |
| Total Submitted Charge Amount | 51422.54 |
| Total Medicare Allowed Amount | 34353.29 |
| Total Medicare Payment Amount | 25353.51 |
| Total Medicare Standardized Payment Amount | 28194.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 38 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 1372.01 |
| Total Drug Medicare AllowedAmount | 782.07 |
| Total Drug Medicare PaymentAmount | 759.62 |
| Total Drug Medicare Standardized Payment Amount | 759.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 1006 |
| Number Of Medicare Beneficiaries With Medical Services | 238 |
| Total Medical Submitted Charge Amount | 50050.53 |
| Total Medical Medicare Allowed Amount | 33571.22 |
| Total Medical Medicare Payment Amount | 24593.89 |
| Total Medical Medicare Standardized Payment Amount | 27435.14 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 116 |
| Number Of Beneficiaries Age 75 to 84 | 56 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 178 |
| Number Of Male Beneficiaries | 60 |
| Number Of Non Hispanic White Beneficiaries | 204 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 180 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9788 |