| National Provider Identifier [NPI]: | 1457478273 |
| Last Name Of The Provider | CHICHAKLI |
| First Name Of The Provider | RAMSEY |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 543 CHALAN GUMA YU'OS |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAMUNING |
| Zip Code Of The Provider | 969133630 |
| State Code Of The Provider | GU |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 915 |
| Number Of Medicare Beneficiaries | 479 |
| Total Submitted Charge Amount | 400964 |
| Total Medicare Allowed Amount | 127599.94 |
| Total Medicare Payment Amount | 92203.26 |
| Total Medicare Standardized Payment Amount | 89690.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 100 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 99275 |
| Total Drug Medicare AllowedAmount | 15971.05 |
| Total Drug Medicare PaymentAmount | 12387.81 |
| Total Drug Medicare Standardized Payment Amount | 12387.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 56 |
| Number Of Medical Services | 815 |
| Number Of Medicare Beneficiaries With Medical Services | 479 |
| Total Medical Submitted Charge Amount | 301689 |
| Total Medical Medicare Allowed Amount | 111628.89 |
| Total Medical Medicare Payment Amount | 79815.45 |
| Total Medical Medicare Standardized Payment Amount | 77302.42 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 242 |
| Number Of Beneficiaries Age 75 to 84 | 145 |
| Number Of Beneficiaries Age Greater 84 | 77 |
| Number Of Female Beneficiaries | 86 |
| Number Of Male Beneficiaries | 393 |
| Number Of Non Hispanic White Beneficiaries | 417 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 456 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 2 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1158 |