| National Provider Identifier [NPI]: | 1306840806 |
| Last Name Of The Provider | LEITER |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6 GLEN COVE DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCKPORT |
| Zip Code Of The Provider | 048564240 |
| 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 | 152 |
| Number Of Services | 4833 |
| Number Of Medicare Beneficiaries | 2389 |
| Total Submitted Charge Amount | 525319 |
| Total Medicare Allowed Amount | 131939.87 |
| Total Medicare Payment Amount | 98808.29 |
| Total Medicare Standardized Payment Amount | 104016.65 |
| 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 | 152 |
| Number Of Medical Services | 4833 |
| Number Of Medicare Beneficiaries With Medical Services | 2389 |
| Total Medical Submitted Charge Amount | 525319 |
| Total Medical Medicare Allowed Amount | 131939.87 |
| Total Medical Medicare Payment Amount | 98808.29 |
| Total Medical Medicare Standardized Payment Amount | 104016.65 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 399 |
| Number Of Beneficiaries Age 65 to 74 | 732 |
| Number Of Beneficiaries Age 75 to 84 | 733 |
| Number Of Beneficiaries Age Greater 84 | 525 |
| Number Of Female Beneficiaries | 1440 |
| Number Of Male Beneficiaries | 949 |
| Number Of Non Hispanic White Beneficiaries | 2322 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1484 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 905 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3856 |