National Provider Identifier [NPI]: |
1023053055 |
Last Name Of The Provider |
HOFFMAN |
First Name Of The Provider |
MARC |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
144 STATE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
041013776 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
632 |
Number Of Medicare Beneficiaries |
509 |
Total Submitted Charge Amount |
237421.18 |
Total Medicare Allowed Amount |
68950.44 |
Total Medicare Payment Amount |
52318.36 |
Total Medicare Standardized Payment Amount |
53380.15 |
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 |
38 |
Number Of Medical Services |
632 |
Number Of Medicare Beneficiaries With Medical Services |
509 |
Total Medical Submitted Charge Amount |
237421.18 |
Total Medical Medicare Allowed Amount |
68950.44 |
Total Medical Medicare Payment Amount |
52318.36 |
Total Medical Medicare Standardized Payment Amount |
53380.15 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
181 |
Number Of Beneficiaries Age 65 to 74 |
129 |
Number Of Beneficiaries Age 75 to 84 |
91 |
Number Of Beneficiaries Age Greater 84 |
108 |
Number Of Female Beneficiaries |
309 |
Number Of Male Beneficiaries |
200 |
Number Of Non Hispanic White Beneficiaries |
492 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
207 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
302 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
46 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5859 |