| National Provider Identifier [NPI]: | 1215139852 |
| Last Name Of The Provider | NINE |
| First Name Of The Provider | ERIK |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 213 DEDHAM AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEEDHAM |
| Zip Code Of The Provider | 024923036 |
| 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 | 186 |
| Number Of Services | 8654 |
| Number Of Medicare Beneficiaries | 3808 |
| Total Submitted Charge Amount | 738935.95 |
| Total Medicare Allowed Amount | 207419.64 |
| Total Medicare Payment Amount | 161420.36 |
| Total Medicare Standardized Payment Amount | 158905.49 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2736 |
| Number Of Medicare Beneficiaries With Drug Services | 36 |
| Total Drug Submitted ChargeAmount | 9886 |
| Total Drug Medicare AllowedAmount | 756.27 |
| Total Drug Medicare PaymentAmount | 592.86 |
| Total Drug Medicare Standardized Payment Amount | 592.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 183 |
| Number Of Medical Services | 5918 |
| Number Of Medicare Beneficiaries With Medical Services | 3808 |
| Total Medical Submitted Charge Amount | 729049.95 |
| Total Medical Medicare Allowed Amount | 206663.37 |
| Total Medical Medicare Payment Amount | 160827.5 |
| Total Medical Medicare Standardized Payment Amount | 158312.63 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 658 |
| Number Of Beneficiaries Age 65 to 74 | 1376 |
| Number Of Beneficiaries Age 75 to 84 | 1120 |
| Number Of Beneficiaries Age Greater 84 | 654 |
| Number Of Female Beneficiaries | 2510 |
| Number Of Male Beneficiaries | 1298 |
| Number Of Non Hispanic White Beneficiaries | 3416 |
| Number Of Black or African American Beneficiaries | 67 |
| Number Of AsianPacific Islander Beneficiaries | 48 |
| Number Of Hispanic Beneficiaries | 222 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 55 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2680 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1128 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5819 |