| National Provider Identifier [NPI]: | 1174508501 |
| Last Name Of The Provider | ERICKSON |
| First Name Of The Provider | JOEL |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2000 W COMMERCIAL BLVD |
| Street Address 2 Of The Provider | SUITE 115 |
| City Of The Provider | FORT LAUDERDALE |
| Zip Code Of The Provider | 333093073 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 230 |
| Number Of Services | 2774 |
| Number Of Medicare Beneficiaries | 1695 |
| Total Submitted Charge Amount | 546190 |
| Total Medicare Allowed Amount | 119090.64 |
| Total Medicare Payment Amount | 89688.9 |
| Total Medicare Standardized Payment Amount | 85670.67 |
| 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 | 230 |
| Number Of Medical Services | 2774 |
| Number Of Medicare Beneficiaries With Medical Services | 1695 |
| Total Medical Submitted Charge Amount | 546190 |
| Total Medical Medicare Allowed Amount | 119090.64 |
| Total Medical Medicare Payment Amount | 89688.9 |
| Total Medical Medicare Standardized Payment Amount | 85670.67 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 423 |
| Number Of Beneficiaries Age 65 to 74 | 499 |
| Number Of Beneficiaries Age 75 to 84 | 414 |
| Number Of Beneficiaries Age Greater 84 | 359 |
| Number Of Female Beneficiaries | 971 |
| Number Of Male Beneficiaries | 724 |
| Number Of Non Hispanic White Beneficiaries | 1118 |
| Number Of Black or African American Beneficiaries | 380 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 141 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 999 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 696 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.4038 |