| National Provider Identifier [NPI]: | 1790760940 |
| Last Name Of The Provider | CHICA |
| First Name Of The Provider | GERARDO |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2391 NE LOOP 410 |
| Street Address 2 Of The Provider | SUITE 405 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782175600 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 93 |
| Number Of Services | 34969 |
| Number Of Medicare Beneficiaries | 713 |
| Total Submitted Charge Amount | 2957465.25 |
| Total Medicare Allowed Amount | 908961.95 |
| Total Medicare Payment Amount | 697930.94 |
| Total Medicare Standardized Payment Amount | 754606.01 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 30653 |
| Number Of Medicare Beneficiaries With Drug Services | 250 |
| Total Drug Submitted ChargeAmount | 98045.25 |
| Total Drug Medicare AllowedAmount | 22568.89 |
| Total Drug Medicare PaymentAmount | 17352.7 |
| Total Drug Medicare Standardized Payment Amount | 17352.7 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 4316 |
| Number Of Medicare Beneficiaries With Medical Services | 713 |
| Total Medical Submitted Charge Amount | 2859420 |
| Total Medical Medicare Allowed Amount | 886393.06 |
| Total Medical Medicare Payment Amount | 680578.24 |
| Total Medical Medicare Standardized Payment Amount | 737253.31 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 260 |
| Number Of Beneficiaries Age 65 to 74 | 214 |
| Number Of Beneficiaries Age 75 to 84 | 184 |
| Number Of Beneficiaries Age Greater 84 | 55 |
| Number Of Female Beneficiaries | 341 |
| Number Of Male Beneficiaries | 372 |
| Number Of Non Hispanic White Beneficiaries | 302 |
| Number Of Black or African American Beneficiaries | 132 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 264 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 469 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 244 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 71 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 5.6911 |