| National Provider Identifier [NPI]: | 1912991159 |
| Last Name Of The Provider | HSU |
| First Name Of The Provider | POWEN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 87 MCGREGOR ST |
| Street Address 2 Of The Provider | SUITE 3200 |
| City Of The Provider | MANCHESTER |
| Zip Code Of The Provider | 031023765 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 30 |
| Number Of Services | 4020 |
| Number Of Medicare Beneficiaries | 875 |
| Total Submitted Charge Amount | 525240 |
| Total Medicare Allowed Amount | 309295.4 |
| Total Medicare Payment Amount | 235825.32 |
| Total Medicare Standardized Payment Amount | 234256.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 65 |
| Number Of Medicare Beneficiaries With Drug Services | 33 |
| Total Drug Submitted ChargeAmount | 980 |
| Total Drug Medicare AllowedAmount | 197.59 |
| Total Drug Medicare PaymentAmount | 140.46 |
| Total Drug Medicare Standardized Payment Amount | 140.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 3955 |
| Number Of Medicare Beneficiaries With Medical Services | 875 |
| Total Medical Submitted Charge Amount | 524260 |
| Total Medical Medicare Allowed Amount | 309097.81 |
| Total Medical Medicare Payment Amount | 235684.86 |
| Total Medical Medicare Standardized Payment Amount | 234115.65 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 248 |
| Number Of Beneficiaries Age 65 to 74 | 252 |
| Number Of Beneficiaries Age 75 to 84 | 251 |
| Number Of Beneficiaries Age Greater 84 | 124 |
| Number Of Female Beneficiaries | 489 |
| Number Of Male Beneficiaries | 386 |
| Number Of Non Hispanic White Beneficiaries | 839 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 685 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 190 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 1.6728 |