| National Provider Identifier [NPI]: | 1568583201 |
| Last Name Of The Provider | MAIN |
| First Name Of The Provider | GERALD |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 602 EXETER LANE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CAMBRIA |
| Zip Code Of The Provider | 93428 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 166 |
| Number Of Services | 3620 |
| Number Of Medicare Beneficiaries | 1943 |
| Total Submitted Charge Amount | 230195 |
| Total Medicare Allowed Amount | 88425.58 |
| Total Medicare Payment Amount | 65231.64 |
| Total Medicare Standardized Payment Amount | 64712.42 |
| 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 | 166 |
| Number Of Medical Services | 3620 |
| Number Of Medicare Beneficiaries With Medical Services | 1943 |
| Total Medical Submitted Charge Amount | 230195 |
| Total Medical Medicare Allowed Amount | 88425.58 |
| Total Medical Medicare Payment Amount | 65231.64 |
| Total Medical Medicare Standardized Payment Amount | 64712.42 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 380 |
| Number Of Beneficiaries Age 65 to 74 | 657 |
| Number Of Beneficiaries Age 75 to 84 | 554 |
| Number Of Beneficiaries Age Greater 84 | 352 |
| Number Of Female Beneficiaries | 1187 |
| Number Of Male Beneficiaries | 756 |
| Number Of Non Hispanic White Beneficiaries | 1197 |
| Number Of Black or African American Beneficiaries | 119 |
| Number Of AsianPacific Islander Beneficiaries | 78 |
| Number Of Hispanic Beneficiaries | 520 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1025 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 918 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 41 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9709 |