| National Provider Identifier [NPI]: | 1710947379 |
| Last Name Of The Provider | CICCARELLI |
| First Name Of The Provider | ARMANN |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 291 QUEEN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRISTOL |
| Zip Code Of The Provider | 060106379 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Plastic and Reconstructive Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 152 |
| Number Of Services | 1313 |
| Number Of Medicare Beneficiaries | 365 |
| Total Submitted Charge Amount | 371080.88 |
| Total Medicare Allowed Amount | 185823.79 |
| Total Medicare Payment Amount | 141164.76 |
| Total Medicare Standardized Payment Amount | 126203.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 239 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 5592.88 |
| Total Drug Medicare AllowedAmount | 3728.38 |
| Total Drug Medicare PaymentAmount | 2917.48 |
| Total Drug Medicare Standardized Payment Amount | 2917.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 150 |
| Number Of Medical Services | 1074 |
| Number Of Medicare Beneficiaries With Medical Services | 365 |
| Total Medical Submitted Charge Amount | 365488 |
| Total Medical Medicare Allowed Amount | 182095.41 |
| Total Medical Medicare Payment Amount | 138247.28 |
| Total Medical Medicare Standardized Payment Amount | 123286.02 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 138 |
| Number Of Beneficiaries Age 75 to 84 | 107 |
| Number Of Beneficiaries Age Greater 84 | 77 |
| Number Of Female Beneficiaries | 211 |
| Number Of Male Beneficiaries | 154 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 284 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 81 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1183 |