| National Provider Identifier [NPI]: | 1093807703 |
| Last Name Of The Provider | GICHERU |
| First Name Of The Provider | SIDNEY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 440 W LBJ FREEWAY |
| Street Address 2 Of The Provider | SUITE 300 PLAZA II |
| City Of The Provider | IRVING |
| Zip Code Of The Provider | 75063 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 1173 |
| Number Of Medicare Beneficiaries | 323 |
| Total Submitted Charge Amount | 361983 |
| Total Medicare Allowed Amount | 144747.5 |
| Total Medicare Payment Amount | 104251.12 |
| Total Medicare Standardized Payment Amount | 104074.9 |
| 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 | 26 |
| Number Of Medical Services | 1173 |
| Number Of Medicare Beneficiaries With Medical Services | 323 |
| Total Medical Submitted Charge Amount | 361983 |
| Total Medical Medicare Allowed Amount | 144747.5 |
| Total Medical Medicare Payment Amount | 104251.12 |
| Total Medical Medicare Standardized Payment Amount | 104074.9 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 195 |
| Number Of Beneficiaries Age 75 to 84 | 93 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 182 |
| Number Of Male Beneficiaries | 141 |
| Number Of Non Hispanic White Beneficiaries | 266 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 307 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8974 |