| National Provider Identifier [NPI]: | 1982663332 |
| Last Name Of The Provider | BIAL |
| First Name Of The Provider | ERICA |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D., M.S. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 330 MOUNT AUBURN ST |
| Street Address 2 Of The Provider | SUITE 300, WYMAN GROUND, MOUNT AUBURN HOSPITAL |
| City Of The Provider | CAMBRIDGE |
| Zip Code Of The Provider | 021385502 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 817 |
| Number Of Medicare Beneficiaries | 138 |
| Total Submitted Charge Amount | 124210.8 |
| Total Medicare Allowed Amount | 46841.67 |
| Total Medicare Payment Amount | 34657.61 |
| Total Medicare Standardized Payment Amount | 34072.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 420 |
| Number Of Medicare Beneficiaries With Drug Services | 66 |
| Total Drug Submitted ChargeAmount | 1513.8 |
| Total Drug Medicare AllowedAmount | 749.32 |
| Total Drug Medicare PaymentAmount | 575.83 |
| Total Drug Medicare Standardized Payment Amount | 575.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 397 |
| Number Of Medicare Beneficiaries With Medical Services | 138 |
| Total Medical Submitted Charge Amount | 122697 |
| Total Medical Medicare Allowed Amount | 46092.35 |
| Total Medical Medicare Payment Amount | 34081.78 |
| Total Medical Medicare Standardized Payment Amount | 33496.48 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 57 |
| Number Of Beneficiaries Age 65 to 74 | 52 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 89 |
| Number Of Male Beneficiaries | 49 |
| Number Of Non Hispanic White Beneficiaries | 122 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 85 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4059 |