| National Provider Identifier [NPI]: | 1952393282 |
| Last Name Of The Provider | JURICH |
| First Name Of The Provider | NICHOLAS |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 374 UNIVERSITY DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | PRESTONSBURG |
| Zip Code Of The Provider | 416531069 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 111 |
| Number Of Services | 7615 |
| Number Of Medicare Beneficiaries | 522 |
| Total Submitted Charge Amount | 439012.76 |
| Total Medicare Allowed Amount | 146536.82 |
| Total Medicare Payment Amount | 106750.72 |
| Total Medicare Standardized Payment Amount | 118355.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 5248 |
| Number Of Medicare Beneficiaries With Drug Services | 170 |
| Total Drug Submitted ChargeAmount | 38096.76 |
| Total Drug Medicare AllowedAmount | 1924.81 |
| Total Drug Medicare PaymentAmount | 1653.41 |
| Total Drug Medicare Standardized Payment Amount | 1653.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 99 |
| Number Of Medical Services | 2367 |
| Number Of Medicare Beneficiaries With Medical Services | 522 |
| Total Medical Submitted Charge Amount | 400916 |
| Total Medical Medicare Allowed Amount | 144612.01 |
| Total Medical Medicare Payment Amount | 105097.31 |
| Total Medical Medicare Standardized Payment Amount | 116702.07 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 212 |
| Number Of Beneficiaries Age 65 to 74 | 200 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 253 |
| Number Of Male Beneficiaries | 269 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 327 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 195 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 46 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2538 |