| National Provider Identifier [NPI]: | 1407893738 |
| Last Name Of The Provider | CICCARELLI |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 30 LOCUST ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NORTHAMPTON |
| Zip Code Of The Provider | 010602052 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 157 |
| Number Of Services | 4054 |
| Number Of Medicare Beneficiaries | 2401 |
| Total Submitted Charge Amount | 428366 |
| Total Medicare Allowed Amount | 126647.03 |
| Total Medicare Payment Amount | 99142.79 |
| Total Medicare Standardized Payment Amount | 98987.24 |
| 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 | 157 |
| Number Of Medical Services | 4054 |
| Number Of Medicare Beneficiaries With Medical Services | 2401 |
| Total Medical Submitted Charge Amount | 428366 |
| Total Medical Medicare Allowed Amount | 126647.03 |
| Total Medical Medicare Payment Amount | 99142.79 |
| Total Medical Medicare Standardized Payment Amount | 98987.24 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 403 |
| Number Of Beneficiaries Age 65 to 74 | 899 |
| Number Of Beneficiaries Age 75 to 84 | 660 |
| Number Of Beneficiaries Age Greater 84 | 439 |
| Number Of Female Beneficiaries | 1581 |
| Number Of Male Beneficiaries | 820 |
| Number Of Non Hispanic White Beneficiaries | 2229 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 75 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1764 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 637 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.368 |