National Provider Identifier [NPI]: |
1023027422 |
Last Name Of The Provider |
MONEKE |
First Name Of The Provider |
LEONARD |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
489 STATE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BANGOR |
Zip Code Of The Provider |
044016616 |
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 |
16 |
Number Of Services |
953 |
Number Of Medicare Beneficiaries |
342 |
Total Submitted Charge Amount |
202119 |
Total Medicare Allowed Amount |
83243.85 |
Total Medicare Payment Amount |
64555.61 |
Total Medicare Standardized Payment Amount |
67451.31 |
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 |
16 |
Number Of Medical Services |
953 |
Number Of Medicare Beneficiaries With Medical Services |
342 |
Total Medical Submitted Charge Amount |
202119 |
Total Medical Medicare Allowed Amount |
83243.85 |
Total Medical Medicare Payment Amount |
64555.61 |
Total Medical Medicare Standardized Payment Amount |
67451.31 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
95 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
46 |
Number Of Female Beneficiaries |
173 |
Number Of Male Beneficiaries |
169 |
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 |
157 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
185 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
47 |
Percent Of With Chronic Kidney Disease |
55 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
51 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
16 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.2194 |