| National Provider Identifier [NPI]: | 1033173091 |
| Last Name Of The Provider | JOSELOW |
| First Name Of The Provider | WANE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 703 RIVERWAY PL |
| Street Address 2 Of The Provider | |
| City Of The Provider | BEDFORD |
| Zip Code Of The Provider | 031106768 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 168 |
| Number Of Services | 6831 |
| Number Of Medicare Beneficiaries | 4388 |
| Total Submitted Charge Amount | 572490 |
| Total Medicare Allowed Amount | 179440.9 |
| Total Medicare Payment Amount | 137923.8 |
| Total Medicare Standardized Payment Amount | 137716.91 |
| 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 | 168 |
| Number Of Medical Services | 6831 |
| Number Of Medicare Beneficiaries With Medical Services | 4388 |
| Total Medical Submitted Charge Amount | 572490 |
| Total Medical Medicare Allowed Amount | 179440.9 |
| Total Medical Medicare Payment Amount | 137923.8 |
| Total Medical Medicare Standardized Payment Amount | 137716.91 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 990 |
| Number Of Beneficiaries Age 65 to 74 | 1652 |
| Number Of Beneficiaries Age 75 to 84 | 1155 |
| Number Of Beneficiaries Age Greater 84 | 591 |
| Number Of Female Beneficiaries | 2694 |
| Number Of Male Beneficiaries | 1694 |
| Number Of Non Hispanic White Beneficiaries | 4176 |
| Number Of Black or African American Beneficiaries | 41 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 84 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 61 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3386 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1002 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3886 |