| National Provider Identifier [NPI]: | 1215132717 |
| Last Name Of The Provider | LIN |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 77 BATES ST |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | LEWISTON |
| Zip Code Of The Provider | 042407637 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 5969 |
| Number Of Medicare Beneficiaries | 510 |
| Total Submitted Charge Amount | 585389.26 |
| Total Medicare Allowed Amount | 179812.78 |
| Total Medicare Payment Amount | 133035.41 |
| Total Medicare Standardized Payment Amount | 140857.17 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 4416 |
| Number Of Medicare Beneficiaries With Drug Services | 128 |
| Total Drug Submitted ChargeAmount | 39124.26 |
| Total Drug Medicare AllowedAmount | 19987.13 |
| Total Drug Medicare PaymentAmount | 15217.11 |
| Total Drug Medicare Standardized Payment Amount | 15217.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 1553 |
| Number Of Medicare Beneficiaries With Medical Services | 510 |
| Total Medical Submitted Charge Amount | 546265 |
| Total Medical Medicare Allowed Amount | 159825.65 |
| Total Medical Medicare Payment Amount | 117818.3 |
| Total Medical Medicare Standardized Payment Amount | 125640.06 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 300 |
| Number Of Beneficiaries Age 65 to 74 | 102 |
| Number Of Beneficiaries Age 75 to 84 | 82 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 325 |
| Number Of Male Beneficiaries | 185 |
| Number Of Non Hispanic White Beneficiaries | 493 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 190 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 320 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 4 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 51 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 2 |
| Average HCC Risk Score Of Beneficiaries | 1.1778 |