National Provider Identifier [NPI]: |
1134351455 |
Last Name Of The Provider |
LEWIS-BROWN |
First Name Of The Provider |
CHRISTEL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
|
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7 PLAZA DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SCARBOROUGH |
Zip Code Of The Provider |
040748996 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Occupational therapist |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
5 |
Number Of Services |
2538 |
Number Of Medicare Beneficiaries |
95 |
Total Submitted Charge Amount |
107200 |
Total Medicare Allowed Amount |
74433.08 |
Total Medicare Payment Amount |
57611.79 |
Total Medicare Standardized Payment Amount |
33327.91 |
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 |
5 |
Number Of Medical Services |
2538 |
Number Of Medicare Beneficiaries With Medical Services |
95 |
Total Medical Submitted Charge Amount |
107200 |
Total Medical Medicare Allowed Amount |
74433.08 |
Total Medical Medicare Payment Amount |
57611.79 |
Total Medical Medicare Standardized Payment Amount |
33327.91 |
Average Age Of Beneficiaries |
83 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
28 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
64 |
Number Of Male Beneficiaries |
31 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
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 |
73 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
22 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
|
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
65 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
25 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
24 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
1.4798 |