| National Provider Identifier [NPI]: | 1013017581 |
| Last Name Of The Provider | STIEN |
| First Name Of The Provider | ERIK |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 40 HART ST |
| Street Address 2 Of The Provider | SUITE B1 |
| City Of The Provider | NEW BRITAIN |
| Zip Code Of The Provider | 060521743 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 135 |
| Number Of Services | 6748 |
| Number Of Medicare Beneficiaries | 1345 |
| Total Submitted Charge Amount | 1071386 |
| Total Medicare Allowed Amount | 221337.6 |
| Total Medicare Payment Amount | 170202.02 |
| Total Medicare Standardized Payment Amount | 156820.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 4807 |
| Number Of Medicare Beneficiaries With Drug Services | 99 |
| Total Drug Submitted ChargeAmount | 6684 |
| Total Drug Medicare AllowedAmount | 3353.13 |
| Total Drug Medicare PaymentAmount | 2605.11 |
| Total Drug Medicare Standardized Payment Amount | 2605.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 133 |
| Number Of Medical Services | 1941 |
| Number Of Medicare Beneficiaries With Medical Services | 1345 |
| Total Medical Submitted Charge Amount | 1064702 |
| Total Medical Medicare Allowed Amount | 217984.47 |
| Total Medical Medicare Payment Amount | 167596.91 |
| Total Medical Medicare Standardized Payment Amount | 154215.34 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 191 |
| Number Of Beneficiaries Age 65 to 74 | 558 |
| Number Of Beneficiaries Age 75 to 84 | 397 |
| Number Of Beneficiaries Age Greater 84 | 199 |
| Number Of Female Beneficiaries | 997 |
| Number Of Male Beneficiaries | 348 |
| Number Of Non Hispanic White Beneficiaries | 1213 |
| Number Of Black or African American Beneficiaries | 38 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 60 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 975 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 370 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2594 |