| National Provider Identifier [NPI]: | 1184621146 |
| Last Name Of The Provider | CICHOWSKI |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 109 NE BIRCH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | COUPEVILLE |
| Zip Code Of The Provider | 98239 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 3839 |
| Number Of Medicare Beneficiaries | 882 |
| Total Submitted Charge Amount | 739842 |
| Total Medicare Allowed Amount | 420294.82 |
| Total Medicare Payment Amount | 303826.22 |
| Total Medicare Standardized Payment Amount | 303535.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 1013 |
| Number Of Medicare Beneficiaries With Drug Services | 56 |
| Total Drug Submitted ChargeAmount | 212555 |
| Total Drug Medicare AllowedAmount | 152685.82 |
| Total Drug Medicare PaymentAmount | 119092.98 |
| Total Drug Medicare Standardized Payment Amount | 119092.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 30 |
| Number Of Medical Services | 2826 |
| Number Of Medicare Beneficiaries With Medical Services | 882 |
| Total Medical Submitted Charge Amount | 527287 |
| Total Medical Medicare Allowed Amount | 267609 |
| Total Medical Medicare Payment Amount | 184733.24 |
| Total Medical Medicare Standardized Payment Amount | 184442.33 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 297 |
| Number Of Beneficiaries Age 75 to 84 | 377 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 553 |
| Number Of Male Beneficiaries | 329 |
| Number Of Non Hispanic White Beneficiaries | 840 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| 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 | 867 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 15 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8931 |