| National Provider Identifier [NPI]: | 1427067495 |
| Last Name Of The Provider | HICKS |
| First Name Of The Provider | NICOLE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | PA |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 145 MISSION RANCH BLVD |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | CHICO |
| Zip Code Of The Provider | 95926 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 790 |
| Number Of Medicare Beneficiaries | 441 |
| Total Submitted Charge Amount | 79319.5 |
| Total Medicare Allowed Amount | 49052.09 |
| Total Medicare Payment Amount | 38111.6 |
| Total Medicare Standardized Payment Amount | 43187.22 |
| 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 | 10 |
| Number Of Medical Services | 790 |
| Number Of Medicare Beneficiaries With Medical Services | 441 |
| Total Medical Submitted Charge Amount | 79319.5 |
| Total Medical Medicare Allowed Amount | 49052.09 |
| Total Medical Medicare Payment Amount | 38111.6 |
| Total Medical Medicare Standardized Payment Amount | 43187.22 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 49 |
| Number Of Beneficiaries Age 65 to 74 | 187 |
| Number Of Beneficiaries Age 75 to 84 | 155 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 235 |
| Number Of Male Beneficiaries | 206 |
| Number Of Non Hispanic White Beneficiaries | 388 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 29 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 337 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 42 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 75 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6693 |