National Provider Identifier [NPI]: |
1902836612 |
Last Name Of The Provider |
CHODKIEWICZ |
First Name Of The Provider |
CATHERINE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
33 WHITING HILL RD |
Street Address 2 Of The Provider |
SUITE 21 |
City Of The Provider |
BREWER |
Zip Code Of The Provider |
044121021 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
766 |
Number Of Medicare Beneficiaries |
300 |
Total Submitted Charge Amount |
131553 |
Total Medicare Allowed Amount |
68485.48 |
Total Medicare Payment Amount |
51840.95 |
Total Medicare Standardized Payment Amount |
54113.9 |
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 |
15 |
Number Of Medical Services |
766 |
Number Of Medicare Beneficiaries With Medical Services |
300 |
Total Medical Submitted Charge Amount |
131553 |
Total Medical Medicare Allowed Amount |
68485.48 |
Total Medical Medicare Payment Amount |
51840.95 |
Total Medical Medicare Standardized Payment Amount |
54113.9 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
122 |
Number Of Beneficiaries Age 75 to 84 |
94 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
141 |
Number Of Male Beneficiaries |
159 |
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 |
176 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
124 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
51 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
2.027 |