| National Provider Identifier [NPI]: | 1669633731 |
| Last Name Of The Provider | GAD |
| First Name Of The Provider | HEBA |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 MEDICAL CENTER DR |
| Street Address 2 Of The Provider | DHMC, DEPARTMENT OF PSYCHIATRY |
| City Of The Provider | LEBANON |
| Zip Code Of The Provider | 037561000 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 757 |
| Number Of Medicare Beneficiaries | 322 |
| Total Submitted Charge Amount | 181792 |
| Total Medicare Allowed Amount | 88046.82 |
| Total Medicare Payment Amount | 67598.13 |
| Total Medicare Standardized Payment Amount | 67094.2 |
| 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 | 13 |
| Number Of Medical Services | 757 |
| Number Of Medicare Beneficiaries With Medical Services | 322 |
| Total Medical Submitted Charge Amount | 181792 |
| Total Medical Medicare Allowed Amount | 88046.82 |
| Total Medical Medicare Payment Amount | 67598.13 |
| Total Medical Medicare Standardized Payment Amount | 67094.2 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 108 |
| Number Of Beneficiaries Age 75 to 84 | 89 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 188 |
| Number Of Male Beneficiaries | 134 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 238 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 84 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 35 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1384 |