| National Provider Identifier [NPI]: | 1265429732 |
| Last Name Of The Provider | THIERMAN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 849 57TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BROOKLYN |
| Zip Code Of The Provider | 112203797 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 168 |
| Number Of Services | 7963 |
| Number Of Medicare Beneficiaries | 3687 |
| Total Submitted Charge Amount | 2791963 |
| Total Medicare Allowed Amount | 504639.16 |
| Total Medicare Payment Amount | 392978.55 |
| Total Medicare Standardized Payment Amount | 321457.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1674 |
| Number Of Medicare Beneficiaries With Drug Services | 49 |
| Total Drug Submitted ChargeAmount | 16740 |
| Total Drug Medicare AllowedAmount | 963.51 |
| Total Drug Medicare PaymentAmount | 755.41 |
| Total Drug Medicare Standardized Payment Amount | 755.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 165 |
| Number Of Medical Services | 6289 |
| Number Of Medicare Beneficiaries With Medical Services | 3687 |
| Total Medical Submitted Charge Amount | 2775223 |
| Total Medical Medicare Allowed Amount | 503675.65 |
| Total Medical Medicare Payment Amount | 392223.14 |
| Total Medical Medicare Standardized Payment Amount | 320702.3 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 494 |
| Number Of Beneficiaries Age 65 to 74 | 1474 |
| Number Of Beneficiaries Age 75 to 84 | 1202 |
| Number Of Beneficiaries Age Greater 84 | 517 |
| Number Of Female Beneficiaries | 2378 |
| Number Of Male Beneficiaries | 1309 |
| Number Of Non Hispanic White Beneficiaries | 1097 |
| Number Of Black or African American Beneficiaries | 360 |
| Number Of AsianPacific Islander Beneficiaries | 1612 |
| Number Of Hispanic Beneficiaries | 577 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1379 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2308 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 22 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6313 |