National Provider Identifier [NPI]: |
1629058284 |
Last Name Of The Provider |
WARE |
First Name Of The Provider |
DONALD |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
50 MARQUIS RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
FREEPORT |
Zip Code Of The Provider |
040326477 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
10 |
Number Of Services |
269 |
Number Of Medicare Beneficiaries |
214 |
Total Submitted Charge Amount |
30523 |
Total Medicare Allowed Amount |
27261.33 |
Total Medicare Payment Amount |
20066.79 |
Total Medicare Standardized Payment Amount |
20882.35 |
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 |
10 |
Number Of Medical Services |
269 |
Number Of Medicare Beneficiaries With Medical Services |
214 |
Total Medical Submitted Charge Amount |
30523 |
Total Medical Medicare Allowed Amount |
27261.33 |
Total Medical Medicare Payment Amount |
20066.79 |
Total Medical Medicare Standardized Payment Amount |
20882.35 |
Average Age Of Beneficiaries |
82 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
74 |
Number Of Beneficiaries Age Greater 84 |
94 |
Number Of Female Beneficiaries |
133 |
Number Of Male Beneficiaries |
81 |
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 |
83 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
131 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
50 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
61 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.3396 |