| National Provider Identifier [NPI]: | 1871688499 |
| Last Name Of The Provider | NIEMIRA |
| First Name Of The Provider | DENISE |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5452 U.S. RT. 5 |
| Street Address 2 Of The Provider | STE. D |
| City Of The Provider | NEWPORT |
| Zip Code Of The Provider | 05855 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 1624 |
| Number Of Medicare Beneficiaries | 345 |
| Total Submitted Charge Amount | 139585.5 |
| Total Medicare Allowed Amount | 101263.88 |
| Total Medicare Payment Amount | 76972.63 |
| Total Medicare Standardized Payment Amount | 81954.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 93 |
| Number Of Medicare Beneficiaries With Drug Services | 92 |
| Total Drug Submitted ChargeAmount | 2795 |
| Total Drug Medicare AllowedAmount | 1332.2 |
| Total Drug Medicare PaymentAmount | 1305.74 |
| Total Drug Medicare Standardized Payment Amount | 1305.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 42 |
| Number Of Medical Services | 1531 |
| Number Of Medicare Beneficiaries With Medical Services | 345 |
| Total Medical Submitted Charge Amount | 136790.5 |
| Total Medical Medicare Allowed Amount | 99931.68 |
| Total Medical Medicare Payment Amount | 75666.89 |
| Total Medical Medicare Standardized Payment Amount | 80648.65 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 169 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 42 |
| Number Of Female Beneficiaries | 257 |
| Number Of Male Beneficiaries | 88 |
| 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 | 252 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 93 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 22 |
| Percent Of With Hypertension | 34 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 21 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9227 |