| National Provider Identifier [NPI]: | 1003860719 |
| Last Name Of The Provider | GALE |
| First Name Of The Provider | JERROLD |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 300 MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEWISTON |
| Zip Code Of The Provider | 042407027 |
| 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 | 207 |
| Number Of Services | 5805 |
| Number Of Medicare Beneficiaries | 3259 |
| Total Submitted Charge Amount | 518588.25 |
| Total Medicare Allowed Amount | 166062.37 |
| Total Medicare Payment Amount | 121114.36 |
| Total Medicare Standardized Payment Amount | 128237.7 |
| 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 | 207 |
| Number Of Medical Services | 5805 |
| Number Of Medicare Beneficiaries With Medical Services | 3259 |
| Total Medical Submitted Charge Amount | 518588.25 |
| Total Medical Medicare Allowed Amount | 166062.37 |
| Total Medical Medicare Payment Amount | 121114.36 |
| Total Medical Medicare Standardized Payment Amount | 128237.7 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 911 |
| Number Of Beneficiaries Age 65 to 74 | 1041 |
| Number Of Beneficiaries Age 75 to 84 | 892 |
| Number Of Beneficiaries Age Greater 84 | 415 |
| Number Of Female Beneficiaries | 2073 |
| Number Of Male Beneficiaries | 1186 |
| Number Of Non Hispanic White Beneficiaries | 3171 |
| Number Of Black or African American Beneficiaries | 19 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1651 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1608 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4379 |