| National Provider Identifier [NPI]: | 1326266503 |
| Last Name Of The Provider | COUTO |
| First Name Of The Provider | COREY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 489 STATE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BANGOR |
| Zip Code Of The Provider | 044016616 |
| 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 | 216 |
| Number Of Services | 6611 |
| Number Of Medicare Beneficiaries | 4571 |
| Total Submitted Charge Amount | 1304775 |
| Total Medicare Allowed Amount | 222022.36 |
| Total Medicare Payment Amount | 166043.77 |
| Total Medicare Standardized Payment Amount | 174823.56 |
| 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 | 216 |
| Number Of Medical Services | 6611 |
| Number Of Medicare Beneficiaries With Medical Services | 4571 |
| Total Medical Submitted Charge Amount | 1304775 |
| Total Medical Medicare Allowed Amount | 222022.36 |
| Total Medical Medicare Payment Amount | 166043.77 |
| Total Medical Medicare Standardized Payment Amount | 174823.56 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 1158 |
| Number Of Beneficiaries Age 65 to 74 | 1564 |
| Number Of Beneficiaries Age 75 to 84 | 1271 |
| Number Of Beneficiaries Age Greater 84 | 578 |
| Number Of Female Beneficiaries | 2560 |
| Number Of Male Beneficiaries | 2011 |
| Number Of Non Hispanic White Beneficiaries | 4446 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 40 |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2359 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2212 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5658 |