| National Provider Identifier [NPI]: | 1073595088 |
| Last Name Of The Provider | MERRIAM |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1 MEDICAL CENTER DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BIDDEFORD |
| Zip Code Of The Provider | 040059422 |
| 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 | 190 |
| Number Of Services | 8538 |
| Number Of Medicare Beneficiaries | 5494 |
| Total Submitted Charge Amount | 1707387 |
| Total Medicare Allowed Amount | 271959.36 |
| Total Medicare Payment Amount | 197866.56 |
| Total Medicare Standardized Payment Amount | 204244.01 |
| 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 | 190 |
| Number Of Medical Services | 8538 |
| Number Of Medicare Beneficiaries With Medical Services | 5494 |
| Total Medical Submitted Charge Amount | 1707387 |
| Total Medical Medicare Allowed Amount | 271959.36 |
| Total Medical Medicare Payment Amount | 197866.56 |
| Total Medical Medicare Standardized Payment Amount | 204244.01 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1279 |
| Number Of Beneficiaries Age 65 to 74 | 1709 |
| Number Of Beneficiaries Age 75 to 84 | 1534 |
| Number Of Beneficiaries Age Greater 84 | 972 |
| Number Of Female Beneficiaries | 3307 |
| Number Of Male Beneficiaries | 2187 |
| Number Of Non Hispanic White Beneficiaries | 5347 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 53 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3180 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2314 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.4585 |