| National Provider Identifier [NPI]: | 1487681375 |
| Last Name Of The Provider | WECHSLER |
| First Name Of The Provider | ELENA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 144 STATE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 041013776 |
| 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 | 159 |
| Number Of Services | 3663 |
| Number Of Medicare Beneficiaries | 2316 |
| Total Submitted Charge Amount | 720578 |
| Total Medicare Allowed Amount | 161324.2 |
| Total Medicare Payment Amount | 122273.94 |
| Total Medicare Standardized Payment Amount | 125561.64 |
| 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 | 159 |
| Number Of Medical Services | 3663 |
| Number Of Medicare Beneficiaries With Medical Services | 2316 |
| Total Medical Submitted Charge Amount | 720578 |
| Total Medical Medicare Allowed Amount | 161324.2 |
| Total Medical Medicare Payment Amount | 122273.94 |
| Total Medical Medicare Standardized Payment Amount | 125561.64 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 602 |
| Number Of Beneficiaries Age 65 to 74 | 725 |
| Number Of Beneficiaries Age 75 to 84 | 587 |
| Number Of Beneficiaries Age Greater 84 | 402 |
| Number Of Female Beneficiaries | 1361 |
| Number Of Male Beneficiaries | 955 |
| Number Of Non Hispanic White Beneficiaries | 2226 |
| Number Of Black or African American Beneficiaries | 22 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1295 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1021 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.385 |