National Provider Identifier [NPI]: |
1942249610 |
Last Name Of The Provider |
DORAN |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5 FOUNDERS STREET |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
WILLIMANTIC |
Zip Code Of The Provider |
06226 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
2146 |
Number Of Medicare Beneficiaries |
502 |
Total Submitted Charge Amount |
341176 |
Total Medicare Allowed Amount |
176241.85 |
Total Medicare Payment Amount |
126696.73 |
Total Medicare Standardized Payment Amount |
119176.24 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
118 |
Number Of Medicare Beneficiaries With Drug Services |
97 |
Total Drug Submitted ChargeAmount |
4355 |
Total Drug Medicare AllowedAmount |
2357.24 |
Total Drug Medicare PaymentAmount |
2259.64 |
Total Drug Medicare Standardized Payment Amount |
2259.64 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
38 |
Number Of Medical Services |
2028 |
Number Of Medicare Beneficiaries With Medical Services |
502 |
Total Medical Submitted Charge Amount |
336821 |
Total Medical Medicare Allowed Amount |
173884.61 |
Total Medical Medicare Payment Amount |
124437.09 |
Total Medical Medicare Standardized Payment Amount |
116916.6 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
74 |
Number Of Beneficiaries Age 65 to 74 |
206 |
Number Of Beneficiaries Age 75 to 84 |
147 |
Number Of Beneficiaries Age Greater 84 |
75 |
Number Of Female Beneficiaries |
250 |
Number Of Male Beneficiaries |
252 |
Number Of Non Hispanic White Beneficiaries |
448 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
35 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
376 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
126 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1636 |