| National Provider Identifier [NPI]: | 1548438435 |
| Last Name Of The Provider | NICELY |
| First Name Of The Provider | CHRISTOPHER |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2000 EOFF ST |
| Street Address 2 Of The Provider | DEPT. OF RADIOLOGY |
| City Of The Provider | WHEELING |
| Zip Code Of The Provider | 260033823 |
| State Code Of The Provider | WV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 194 |
| Number Of Services | 4767 |
| Number Of Medicare Beneficiaries | 2472 |
| Total Submitted Charge Amount | 399227 |
| Total Medicare Allowed Amount | 112017.39 |
| Total Medicare Payment Amount | 84275.73 |
| Total Medicare Standardized Payment Amount | 87858.22 |
| 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 | 194 |
| Number Of Medical Services | 4767 |
| Number Of Medicare Beneficiaries With Medical Services | 2472 |
| Total Medical Submitted Charge Amount | 399227 |
| Total Medical Medicare Allowed Amount | 112017.39 |
| Total Medical Medicare Payment Amount | 84275.73 |
| Total Medical Medicare Standardized Payment Amount | 87858.22 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 607 |
| Number Of Beneficiaries Age 65 to 74 | 932 |
| Number Of Beneficiaries Age 75 to 84 | 592 |
| Number Of Beneficiaries Age Greater 84 | 341 |
| Number Of Female Beneficiaries | 1602 |
| Number Of Male Beneficiaries | 870 |
| Number Of Non Hispanic White Beneficiaries | 2388 |
| Number Of Black or African American Beneficiaries | 57 |
| 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 | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1508 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 964 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5204 |