| National Provider Identifier [NPI]: | 1427080027 |
| Last Name Of The Provider | LICHTY |
| First Name Of The Provider | DAN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 823 N MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MCPHERSON |
| Zip Code Of The Provider | 674602839 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 92 |
| Number Of Services | 1435 |
| Number Of Medicare Beneficiaries | 252 |
| Total Submitted Charge Amount | 150693 |
| Total Medicare Allowed Amount | 107314.74 |
| Total Medicare Payment Amount | 73862.99 |
| Total Medicare Standardized Payment Amount | 78809.21 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 146 |
| Number Of Medicare Beneficiaries With Drug Services | 57 |
| Total Drug Submitted ChargeAmount | 1981 |
| Total Drug Medicare AllowedAmount | 1061.72 |
| Total Drug Medicare PaymentAmount | 877.95 |
| Total Drug Medicare Standardized Payment Amount | 877.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 1289 |
| Number Of Medicare Beneficiaries With Medical Services | 252 |
| Total Medical Submitted Charge Amount | 148712 |
| Total Medical Medicare Allowed Amount | 106253.02 |
| Total Medical Medicare Payment Amount | 72985.04 |
| Total Medical Medicare Standardized Payment Amount | 77931.26 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 57 |
| Number Of Beneficiaries Age 75 to 84 | 84 |
| Number Of Beneficiaries Age Greater 84 | 70 |
| Number Of Female Beneficiaries | 142 |
| Number Of Male Beneficiaries | 110 |
| 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 | 186 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 66 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 31 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1491 |