| National Provider Identifier [NPI]: | 1114153855 |
| Last Name Of The Provider | MICKUS |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 320 E NORTH AVE |
| Street Address 2 Of The Provider | LEVEL 01 |
| City Of The Provider | PITTSBURGH |
| Zip Code Of The Provider | 152124756 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 126 |
| Number Of Services | 6271 |
| Number Of Medicare Beneficiaries | 3639 |
| Total Submitted Charge Amount | 587212 |
| Total Medicare Allowed Amount | 122036.9 |
| Total Medicare Payment Amount | 93438.4 |
| Total Medicare Standardized Payment Amount | 97034.78 |
| 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 | 126 |
| Number Of Medical Services | 6271 |
| Number Of Medicare Beneficiaries With Medical Services | 3639 |
| Total Medical Submitted Charge Amount | 587212 |
| Total Medical Medicare Allowed Amount | 122036.9 |
| Total Medical Medicare Payment Amount | 93438.4 |
| Total Medical Medicare Standardized Payment Amount | 97034.78 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 773 |
| Number Of Beneficiaries Age 65 to 74 | 1092 |
| Number Of Beneficiaries Age 75 to 84 | 943 |
| Number Of Beneficiaries Age Greater 84 | 831 |
| Number Of Female Beneficiaries | 1946 |
| Number Of Male Beneficiaries | 1693 |
| Number Of Non Hispanic White Beneficiaries | 3123 |
| Number Of Black or African American Beneficiaries | 446 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2576 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1063 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 46 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 18 |
| Average HCC Risk Score Of Beneficiaries | 2.1239 |