| National Provider Identifier [NPI]: | 1003910126 |
| Last Name Of The Provider | STEIDL |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 53 SEWALL STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 041022625 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 10471 |
| Number Of Medicare Beneficiaries | 766 |
| Total Submitted Charge Amount | 4328604.9 |
| Total Medicare Allowed Amount | 3106805.25 |
| Total Medicare Payment Amount | 2411935.49 |
| Total Medicare Standardized Payment Amount | 2405905.1 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 5904 |
| Number Of Medicare Beneficiaries With Drug Services | 227 |
| Total Drug Submitted ChargeAmount | 3300867 |
| Total Drug Medicare AllowedAmount | 2619123.11 |
| Total Drug Medicare PaymentAmount | 2051623.6 |
| Total Drug Medicare Standardized Payment Amount | 2051623.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 4567 |
| Number Of Medicare Beneficiaries With Medical Services | 766 |
| Total Medical Submitted Charge Amount | 1027737.9 |
| Total Medical Medicare Allowed Amount | 487682.14 |
| Total Medical Medicare Payment Amount | 360311.89 |
| Total Medical Medicare Standardized Payment Amount | 354281.5 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 231 |
| Number Of Beneficiaries Age 75 to 84 | 278 |
| Number Of Beneficiaries Age Greater 84 | 213 |
| Number Of Female Beneficiaries | 466 |
| Number Of Male Beneficiaries | 300 |
| Number Of Non Hispanic White Beneficiaries | 748 |
| 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 | 589 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 177 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4138 |