| National Provider Identifier [NPI]: | 1194772491 |
| Last Name Of The Provider | NIEMI |
| First Name Of The Provider | ERIK |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 322 DEWEY ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BENNINGTON |
| Zip Code Of The Provider | 052012225 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 2082 |
| Number Of Medicare Beneficiaries | 1180 |
| Total Submitted Charge Amount | 569698 |
| Total Medicare Allowed Amount | 285806.65 |
| Total Medicare Payment Amount | 204371.87 |
| Total Medicare Standardized Payment Amount | 202954.72 |
| 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 | 36 |
| Number Of Medical Services | 2082 |
| Number Of Medicare Beneficiaries With Medical Services | 1180 |
| Total Medical Submitted Charge Amount | 569698 |
| Total Medical Medicare Allowed Amount | 285806.65 |
| Total Medical Medicare Payment Amount | 204371.87 |
| Total Medical Medicare Standardized Payment Amount | 202954.72 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 147 |
| Number Of Beneficiaries Age 65 to 74 | 475 |
| Number Of Beneficiaries Age 75 to 84 | 354 |
| Number Of Beneficiaries Age Greater 84 | 204 |
| Number Of Female Beneficiaries | 696 |
| Number Of Male Beneficiaries | 484 |
| Number Of Non Hispanic White Beneficiaries | 1124 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 32 |
| Number Of Beneficiaries With Medicare Only Entitlement | 905 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 275 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0734 |