| National Provider Identifier [NPI]: | 1891809083 |
| Last Name Of The Provider | KUTSEN |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 95 CAMPUS AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEWISTON |
| Zip Code Of The Provider | 042406055 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 1002 |
| Number Of Medicare Beneficiaries | 550 |
| Total Submitted Charge Amount | 761599 |
| Total Medicare Allowed Amount | 108341.76 |
| Total Medicare Payment Amount | 83527.9 |
| Total Medicare Standardized Payment Amount | 83273.2 |
| 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 | 31 |
| Number Of Medical Services | 1002 |
| Number Of Medicare Beneficiaries With Medical Services | 550 |
| Total Medical Submitted Charge Amount | 761599 |
| Total Medical Medicare Allowed Amount | 108341.76 |
| Total Medical Medicare Payment Amount | 83527.9 |
| Total Medical Medicare Standardized Payment Amount | 83273.2 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 114 |
| Number Of Beneficiaries Age 65 to 74 | 165 |
| Number Of Beneficiaries Age 75 to 84 | 152 |
| Number Of Beneficiaries Age Greater 84 | 119 |
| Number Of Female Beneficiaries | 339 |
| Number Of Male Beneficiaries | 211 |
| Number Of Non Hispanic White Beneficiaries | 316 |
| Number Of Black or African American Beneficiaries | 88 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 122 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 348 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 202 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 34 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 53 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 41 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.6353 |