| National Provider Identifier [NPI]: | 1730342791 |
| Last Name Of The Provider | SICA |
| First Name Of The Provider | CARISSA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 701 ENTERPRISE RD E |
| Street Address 2 Of The Provider | SUITE 910 |
| City Of The Provider | SAFETY HARBOR |
| Zip Code Of The Provider | 346955350 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 15 |
| Number Of Services | 7386 |
| Number Of Medicare Beneficiaries | 2283 |
| Total Submitted Charge Amount | 388271.88 |
| Total Medicare Allowed Amount | 369902.01 |
| Total Medicare Payment Amount | 262757.48 |
| Total Medicare Standardized Payment Amount | 264486.21 |
| 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 | 15 |
| Number Of Medical Services | 7386 |
| Number Of Medicare Beneficiaries With Medical Services | 2283 |
| Total Medical Submitted Charge Amount | 388271.88 |
| Total Medical Medicare Allowed Amount | 369902.01 |
| Total Medical Medicare Payment Amount | 262757.48 |
| Total Medical Medicare Standardized Payment Amount | 264486.21 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 159 |
| Number Of Beneficiaries Age 65 to 74 | 305 |
| Number Of Beneficiaries Age 75 to 84 | 667 |
| Number Of Beneficiaries Age Greater 84 | 1152 |
| Number Of Female Beneficiaries | 1522 |
| Number Of Male Beneficiaries | 761 |
| Number Of Non Hispanic White Beneficiaries | 1744 |
| Number Of Black or African American Beneficiaries | 271 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 226 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 902 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1381 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 61 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 21 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.4851 |