National Provider Identifier [NPI]: |
1184662439 |
Last Name Of The Provider |
DELEHANTY |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
16 FAHEY ST |
Street Address 2 Of The Provider |
SUITE 208 COBB MED. BLDG |
City Of The Provider |
BELFAST |
Zip Code Of The Provider |
049156029 |
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 |
21 |
Number Of Services |
1202 |
Number Of Medicare Beneficiaries |
354 |
Total Submitted Charge Amount |
127244.64 |
Total Medicare Allowed Amount |
94290.16 |
Total Medicare Payment Amount |
67828.98 |
Total Medicare Standardized Payment Amount |
75386.61 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
124 |
Number Of Medicare Beneficiaries With Drug Services |
123 |
Total Drug Submitted ChargeAmount |
1920 |
Total Drug Medicare AllowedAmount |
1564.8 |
Total Drug Medicare PaymentAmount |
1521.8 |
Total Drug Medicare Standardized Payment Amount |
1521.8 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
1078 |
Number Of Medicare Beneficiaries With Medical Services |
354 |
Total Medical Submitted Charge Amount |
125324.64 |
Total Medical Medicare Allowed Amount |
92725.36 |
Total Medical Medicare Payment Amount |
66307.18 |
Total Medical Medicare Standardized Payment Amount |
73864.81 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
120 |
Number Of Beneficiaries Age Greater 84 |
63 |
Number Of Female Beneficiaries |
205 |
Number Of Male Beneficiaries |
149 |
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 |
249 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
105 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
34 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8448 |