| National Provider Identifier [NPI]: | 1588643993 |
| Last Name Of The Provider | LICATA |
| First Name Of The Provider | ANTHONY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 301 S 7TH AVE |
| Street Address 2 Of The Provider | SUITE 2020 |
| City Of The Provider | WEST READING |
| Zip Code Of The Provider | 196111410 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 71 |
| Number Of Services | 5909 |
| Number Of Medicare Beneficiaries | 2841 |
| Total Submitted Charge Amount | 1223688.18 |
| Total Medicare Allowed Amount | 484404.64 |
| Total Medicare Payment Amount | 365563.21 |
| Total Medicare Standardized Payment Amount | 389768.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 688 |
| Number Of Medicare Beneficiaries With Drug Services | 176 |
| Total Drug Submitted ChargeAmount | 40276.5 |
| Total Drug Medicare AllowedAmount | 31696.64 |
| Total Drug Medicare PaymentAmount | 24563.15 |
| Total Drug Medicare Standardized Payment Amount | 24563.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 5221 |
| Number Of Medicare Beneficiaries With Medical Services | 2841 |
| Total Medical Submitted Charge Amount | 1183411.68 |
| Total Medical Medicare Allowed Amount | 452708 |
| Total Medical Medicare Payment Amount | 341000.06 |
| Total Medical Medicare Standardized Payment Amount | 365205.12 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 340 |
| Number Of Beneficiaries Age 65 to 74 | 926 |
| Number Of Beneficiaries Age 75 to 84 | 985 |
| Number Of Beneficiaries Age Greater 84 | 590 |
| Number Of Female Beneficiaries | 1409 |
| Number Of Male Beneficiaries | 1432 |
| Number Of Non Hispanic White Beneficiaries | 2541 |
| Number Of Black or African American Beneficiaries | 91 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 162 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2420 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 421 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 63 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6542 |