| National Provider Identifier [NPI]: | 1205878857 |
| Last Name Of The Provider | EWY |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 21 RIVERS EDGE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | KENNEBUNK |
| Zip Code Of The Provider | 040437739 |
| 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 | 279 |
| Number Of Services | 20890 |
| Number Of Medicare Beneficiaries | 11181 |
| Total Submitted Charge Amount | 2607965 |
| Total Medicare Allowed Amount | 584631.58 |
| Total Medicare Payment Amount | 459271.78 |
| Total Medicare Standardized Payment Amount | 478291.15 |
| 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 | 279 |
| Number Of Medical Services | 20890 |
| Number Of Medicare Beneficiaries With Medical Services | 11181 |
| Total Medical Submitted Charge Amount | 2607965 |
| Total Medical Medicare Allowed Amount | 584631.58 |
| Total Medical Medicare Payment Amount | 459271.78 |
| Total Medical Medicare Standardized Payment Amount | 478291.15 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 2305 |
| Number Of Beneficiaries Age 65 to 74 | 3639 |
| Number Of Beneficiaries Age 75 to 84 | 3208 |
| Number Of Beneficiaries Age Greater 84 | 2029 |
| Number Of Female Beneficiaries | 6774 |
| Number Of Male Beneficiaries | 4407 |
| Number Of Non Hispanic White Beneficiaries | 10388 |
| Number Of Black or African American Beneficiaries | 166 |
| Number Of AsianPacific Islander Beneficiaries | 46 |
| Number Of Hispanic Beneficiaries | 379 |
| Number Of American Indian Alaska Native Beneficiaries | 72 |
| Number Of Beneficiaries With Race Not Else where Classified | 130 |
| Number Of Beneficiaries With Medicare Only Entitlement | 6981 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 4200 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5451 |