National Provider Identifier [NPI]: |
1750404596 |
Last Name Of The Provider |
CARIN |
First Name Of The Provider |
DOROTHY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
55 REYNOLDS RD |
Street Address 2 Of The Provider |
BOX 159 |
City Of The Provider |
BROOKS |
Zip Code Of The Provider |
049213637 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
428 |
Number Of Medicare Beneficiaries |
144 |
Total Submitted Charge Amount |
66996.25 |
Total Medicare Allowed Amount |
31244.3 |
Total Medicare Payment Amount |
18213.52 |
Total Medicare Standardized Payment Amount |
18464.54 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
19 |
Number Of Medicare Beneficiaries With Drug Services |
14 |
Total Drug Submitted ChargeAmount |
410 |
Total Drug Medicare AllowedAmount |
340 |
Total Drug Medicare PaymentAmount |
328.06 |
Total Drug Medicare Standardized Payment Amount |
328.06 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
409 |
Number Of Medicare Beneficiaries With Medical Services |
144 |
Total Medical Submitted Charge Amount |
66586.25 |
Total Medical Medicare Allowed Amount |
30904.3 |
Total Medical Medicare Payment Amount |
17885.46 |
Total Medical Medicare Standardized Payment Amount |
18136.48 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
26 |
Number Of Beneficiaries Age 65 to 74 |
53 |
Number Of Beneficiaries Age 75 to 84 |
33 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
112 |
Number Of Male Beneficiaries |
32 |
Number Of Non Hispanic White Beneficiaries |
123 |
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 |
108 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.3195 |