| National Provider Identifier [NPI]: | 1467408310 |
| Last Name Of The Provider | PACHTA-GALLIGAN |
| First Name Of The Provider | JANET |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 331 VERANDA ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 041035545 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 96 |
| Number Of Services | 1835 |
| Number Of Medicare Beneficiaries | 231 |
| Total Submitted Charge Amount | 118383.75 |
| Total Medicare Allowed Amount | 65154.44 |
| Total Medicare Payment Amount | 51974.32 |
| Total Medicare Standardized Payment Amount | 52439.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 42 |
| Number Of Medicare Beneficiaries With Drug Services | 35 |
| Total Drug Submitted ChargeAmount | 4447.75 |
| Total Drug Medicare AllowedAmount | 3112.37 |
| Total Drug Medicare PaymentAmount | 3045.97 |
| Total Drug Medicare Standardized Payment Amount | 3045.97 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 91 |
| Number Of Medical Services | 1793 |
| Number Of Medicare Beneficiaries With Medical Services | 231 |
| Total Medical Submitted Charge Amount | 113936 |
| Total Medical Medicare Allowed Amount | 62042.07 |
| Total Medical Medicare Payment Amount | 48928.35 |
| Total Medical Medicare Standardized Payment Amount | 49393.73 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 87 |
| Number Of Beneficiaries Age 75 to 84 | 68 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 186 |
| Number Of Male Beneficiaries | 45 |
| Number Of Non Hispanic White Beneficiaries | 220 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 161 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 70 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 19 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9884 |