| National Provider Identifier [NPI]: | 1922170059 |
| Last Name Of The Provider | APPLEBAUM |
| First Name Of The Provider | BRETT |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 22 BRAMHALL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 041023134 |
| 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 | 120 |
| Number Of Services | 3636 |
| Number Of Medicare Beneficiaries | 2844 |
| Total Submitted Charge Amount | 1012618 |
| Total Medicare Allowed Amount | 158895.05 |
| Total Medicare Payment Amount | 118205.88 |
| Total Medicare Standardized Payment Amount | 122063.75 |
| 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 | 120 |
| Number Of Medical Services | 3636 |
| Number Of Medicare Beneficiaries With Medical Services | 2844 |
| Total Medical Submitted Charge Amount | 1012618 |
| Total Medical Medicare Allowed Amount | 158895.05 |
| Total Medical Medicare Payment Amount | 118205.88 |
| Total Medical Medicare Standardized Payment Amount | 122063.75 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 618 |
| Number Of Beneficiaries Age 65 to 74 | 907 |
| Number Of Beneficiaries Age 75 to 84 | 799 |
| Number Of Beneficiaries Age Greater 84 | 520 |
| Number Of Female Beneficiaries | 1608 |
| Number Of Male Beneficiaries | 1236 |
| Number Of Non Hispanic White Beneficiaries | 2763 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1769 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1075 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.403 |