| National Provider Identifier [NPI]: | 1205863958 |
| Last Name Of The Provider | KEENAN |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD, PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 HOSPITAL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | BENNINGTON |
| Zip Code Of The Provider | 052015004 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 164 |
| Number Of Services | 2407 |
| Number Of Medicare Beneficiaries | 1313 |
| Total Submitted Charge Amount | 257819 |
| Total Medicare Allowed Amount | 81049.04 |
| Total Medicare Payment Amount | 65644.87 |
| Total Medicare Standardized Payment Amount | 67070.1 |
| 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 | 164 |
| Number Of Medical Services | 2407 |
| Number Of Medicare Beneficiaries With Medical Services | 1313 |
| Total Medical Submitted Charge Amount | 257819 |
| Total Medical Medicare Allowed Amount | 81049.04 |
| Total Medical Medicare Payment Amount | 65644.87 |
| Total Medical Medicare Standardized Payment Amount | 67070.1 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 232 |
| Number Of Beneficiaries Age 65 to 74 | 559 |
| Number Of Beneficiaries Age 75 to 84 | 353 |
| Number Of Beneficiaries Age Greater 84 | 169 |
| Number Of Female Beneficiaries | 960 |
| Number Of Male Beneficiaries | 353 |
| Number Of Non Hispanic White Beneficiaries | 1275 |
| 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 | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 948 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 365 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2017 |