| National Provider Identifier [NPI]: | 1174535090 |
| Last Name Of The Provider | ABBOTT |
| First Name Of The Provider | MAXWELL |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2925 RYAN DR SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SALEM |
| Zip Code Of The Provider | 973019687 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 208 |
| Number Of Services | 5347 |
| Number Of Medicare Beneficiaries | 3283 |
| Total Submitted Charge Amount | 493274.86 |
| Total Medicare Allowed Amount | 168954.21 |
| Total Medicare Payment Amount | 129297.22 |
| Total Medicare Standardized Payment Amount | 132893.84 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 729 |
| Number Of Beneficiaries Age 65 to 74 | 1198 |
| Number Of Beneficiaries Age 75 to 84 | 874 |
| Number Of Beneficiaries Age Greater 84 | 482 |
| Number Of Female Beneficiaries | 2079 |
| Number Of Male Beneficiaries | 1204 |
| Number Of Non Hispanic White Beneficiaries | 2663 |
| Number Of Black or African American Beneficiaries | 148 |
| Number Of AsianPacific Islander Beneficiaries | 53 |
| Number Of Hispanic Beneficiaries | 354 |
| Number Of American Indian Alaska Native Beneficiaries | 31 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2378 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 905 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5598 |