| National Provider Identifier [NPI]: | 1174565667 |
| Last Name Of The Provider | PICKUS |
| First Name Of The Provider | OWEN |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2 CHABOT ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WESTBROOK |
| Zip Code Of The Provider | 040924817 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Hematology/Oncology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 222 |
| Number Of Services | 54737 |
| Number Of Medicare Beneficiaries | 1463 |
| Total Submitted Charge Amount | 2603032.37 |
| Total Medicare Allowed Amount | 1356375.25 |
| Total Medicare Payment Amount | 1069466.05 |
| Total Medicare Standardized Payment Amount | 1072668.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 42 |
| Number Of Drug Services | 33921 |
| Number Of Medicare Beneficiaries With Drug Services | 225 |
| Total Drug Submitted ChargeAmount | 1114096.64 |
| Total Drug Medicare AllowedAmount | 825376.39 |
| Total Drug Medicare PaymentAmount | 634650.19 |
| Total Drug Medicare Standardized Payment Amount | 634650.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 180 |
| Number Of Medical Services | 20816 |
| Number Of Medicare Beneficiaries With Medical Services | 1463 |
| Total Medical Submitted Charge Amount | 1488935.73 |
| Total Medical Medicare Allowed Amount | 530998.86 |
| Total Medical Medicare Payment Amount | 434815.86 |
| Total Medical Medicare Standardized Payment Amount | 438018.28 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 409 |
| Number Of Beneficiaries Age 65 to 74 | 525 |
| Number Of Beneficiaries Age 75 to 84 | 368 |
| Number Of Beneficiaries Age Greater 84 | 161 |
| Number Of Female Beneficiaries | 831 |
| Number Of Male Beneficiaries | 632 |
| Number Of Non Hispanic White Beneficiaries | 1424 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 840 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 623 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.1441 |