| National Provider Identifier [NPI]: | 1174556005 |
| Last Name Of The Provider | CEKLENIAK |
| First Name Of The Provider | JULIE |
| 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 | 84 MARGINAL WAY |
| Street Address 2 Of The Provider | SUITE 700 |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 041012443 |
| 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 | 83 |
| Number Of Services | 1539 |
| Number Of Medicare Beneficiaries | 195 |
| Total Submitted Charge Amount | 105792 |
| Total Medicare Allowed Amount | 51647.83 |
| Total Medicare Payment Amount | 40369.31 |
| Total Medicare Standardized Payment Amount | 40538.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 82 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 3296 |
| Total Drug Medicare AllowedAmount | 2475.02 |
| Total Drug Medicare PaymentAmount | 2402.94 |
| Total Drug Medicare Standardized Payment Amount | 2402.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 1457 |
| Number Of Medicare Beneficiaries With Medical Services | 195 |
| Total Medical Submitted Charge Amount | 102496 |
| Total Medical Medicare Allowed Amount | 49172.81 |
| Total Medical Medicare Payment Amount | 37966.37 |
| Total Medical Medicare Standardized Payment Amount | 38135.94 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 11 |
| Number Of Beneficiaries Age 65 to 74 | 74 |
| Number Of Beneficiaries Age 75 to 84 | 65 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 133 |
| Number Of Male Beneficiaries | 62 |
| 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 | 177 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8912 |