| National Provider Identifier [NPI]: | 1134291040 |
| Last Name Of The Provider | LANDES |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 22 BRAMHALL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 041023134 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 165 |
| Number Of Services | 3156 |
| Number Of Medicare Beneficiaries | 2360 |
| Total Submitted Charge Amount | 680084 |
| Total Medicare Allowed Amount | 114769.35 |
| Total Medicare Payment Amount | 86523.81 |
| Total Medicare Standardized Payment Amount | 90413.61 |
| 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 | 165 |
| Number Of Medical Services | 3156 |
| Number Of Medicare Beneficiaries With Medical Services | 2360 |
| Total Medical Submitted Charge Amount | 680084 |
| Total Medical Medicare Allowed Amount | 114769.35 |
| Total Medical Medicare Payment Amount | 86523.81 |
| Total Medical Medicare Standardized Payment Amount | 90413.61 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 475 |
| Number Of Beneficiaries Age 65 to 74 | 787 |
| Number Of Beneficiaries Age 75 to 84 | 716 |
| Number Of Beneficiaries Age Greater 84 | 382 |
| Number Of Female Beneficiaries | 1342 |
| Number Of Male Beneficiaries | 1018 |
| Number Of Non Hispanic White Beneficiaries | 2274 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1425 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 935 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5966 |