| National Provider Identifier [NPI]: | 1093892218 |
| Last Name Of The Provider | FRIEDEL |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 MAIN ST |
| Street Address 2 Of The Provider | DEPT OF RADIOLOGY |
| City Of The Provider | LEWISTON |
| Zip Code Of The Provider | 042407027 |
| 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 | 211 |
| Number Of Services | 4930 |
| Number Of Medicare Beneficiaries | 2842 |
| Total Submitted Charge Amount | 666989 |
| Total Medicare Allowed Amount | 170160.66 |
| Total Medicare Payment Amount | 125522.64 |
| Total Medicare Standardized Payment Amount | 132617.56 |
| 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 | 211 |
| Number Of Medical Services | 4930 |
| Number Of Medicare Beneficiaries With Medical Services | 2842 |
| Total Medical Submitted Charge Amount | 666989 |
| Total Medical Medicare Allowed Amount | 170160.66 |
| Total Medical Medicare Payment Amount | 125522.64 |
| Total Medical Medicare Standardized Payment Amount | 132617.56 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 795 |
| Number Of Beneficiaries Age 65 to 74 | 891 |
| Number Of Beneficiaries Age 75 to 84 | 772 |
| Number Of Beneficiaries Age Greater 84 | 384 |
| Number Of Female Beneficiaries | 1663 |
| Number Of Male Beneficiaries | 1179 |
| Number Of Non Hispanic White Beneficiaries | 2770 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1378 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1464 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5844 |