National Provider Identifier [NPI]: |
1598758351 |
Last Name Of The Provider |
MILLER |
First Name Of The Provider |
MARC |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
51 SEWALL ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
041022643 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Rheumatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
72 |
Number Of Services |
10900 |
Number Of Medicare Beneficiaries |
644 |
Total Submitted Charge Amount |
780556.02 |
Total Medicare Allowed Amount |
476768.56 |
Total Medicare Payment Amount |
365512.46 |
Total Medicare Standardized Payment Amount |
365630.92 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
14 |
Number Of Drug Services |
8196 |
Number Of Medicare Beneficiaries With Drug Services |
86 |
Total Drug Submitted ChargeAmount |
454629.02 |
Total Drug Medicare AllowedAmount |
320382.21 |
Total Drug Medicare PaymentAmount |
251162.51 |
Total Drug Medicare Standardized Payment Amount |
251162.51 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
58 |
Number Of Medical Services |
2704 |
Number Of Medicare Beneficiaries With Medical Services |
644 |
Total Medical Submitted Charge Amount |
325927 |
Total Medical Medicare Allowed Amount |
156386.35 |
Total Medical Medicare Payment Amount |
114349.95 |
Total Medical Medicare Standardized Payment Amount |
114468.41 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
98 |
Number Of Beneficiaries Age 65 to 74 |
268 |
Number Of Beneficiaries Age 75 to 84 |
194 |
Number Of Beneficiaries Age Greater 84 |
84 |
Number Of Female Beneficiaries |
422 |
Number Of Male Beneficiaries |
222 |
Number Of Non Hispanic White Beneficiaries |
627 |
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 |
465 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
179 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
1.3481 |