| National Provider Identifier [NPI]: | 1942388913 |
| Last Name Of The Provider | PANCOE |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 489 STATE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BANGOR |
| Zip Code Of The Provider | 044016616 |
| 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 | 191 |
| Number Of Services | 6650 |
| Number Of Medicare Beneficiaries | 4788 |
| Total Submitted Charge Amount | 917250 |
| Total Medicare Allowed Amount | 168166.95 |
| Total Medicare Payment Amount | 130082.96 |
| Total Medicare Standardized Payment Amount | 136582.49 |
| 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 | 191 |
| Number Of Medical Services | 6650 |
| Number Of Medicare Beneficiaries With Medical Services | 4788 |
| Total Medical Submitted Charge Amount | 917250 |
| Total Medical Medicare Allowed Amount | 168166.95 |
| Total Medical Medicare Payment Amount | 130082.96 |
| Total Medical Medicare Standardized Payment Amount | 136582.49 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 1247 |
| Number Of Beneficiaries Age 65 to 74 | 1799 |
| Number Of Beneficiaries Age 75 to 84 | 1229 |
| Number Of Beneficiaries Age Greater 84 | 513 |
| Number Of Female Beneficiaries | 3091 |
| Number Of Male Beneficiaries | 1697 |
| Number Of Non Hispanic White Beneficiaries | 4659 |
| Number Of Black or African American Beneficiaries | 17 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 14 |
| Number Of American Indian Alaska Native Beneficiaries | 32 |
| Number Of Beneficiaries With Race Not Else where Classified | 50 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2476 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2312 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.398 |