| National Provider Identifier [NPI]: | 1710972518 |
| Last Name Of The Provider | NICEFORO |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 31 STILES RD |
| Street Address 2 Of The Provider | STE 1200 |
| City Of The Provider | SALEM |
| Zip Code Of The Provider | 030792897 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 198 |
| Number Of Services | 8515 |
| Number Of Medicare Beneficiaries | 2510 |
| Total Submitted Charge Amount | 729503.05 |
| Total Medicare Allowed Amount | 279285.59 |
| Total Medicare Payment Amount | 222414.07 |
| Total Medicare Standardized Payment Amount | 215939.12 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3804 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 1544.24 |
| Total Drug Medicare AllowedAmount | 862.56 |
| Total Drug Medicare PaymentAmount | 676.18 |
| Total Drug Medicare Standardized Payment Amount | 676.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 196 |
| Number Of Medical Services | 4711 |
| Number Of Medicare Beneficiaries With Medical Services | 2509 |
| Total Medical Submitted Charge Amount | 727958.81 |
| Total Medical Medicare Allowed Amount | 278423.03 |
| Total Medical Medicare Payment Amount | 221737.89 |
| Total Medical Medicare Standardized Payment Amount | 215262.94 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 378 |
| Number Of Beneficiaries Age 65 to 74 | 993 |
| Number Of Beneficiaries Age 75 to 84 | 736 |
| Number Of Beneficiaries Age Greater 84 | 403 |
| Number Of Female Beneficiaries | 1700 |
| Number Of Male Beneficiaries | 810 |
| Number Of Non Hispanic White Beneficiaries | 2379 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 47 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2057 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 453 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3529 |