National Provider Identifier [NPI]: |
1689690216 |
Last Name Of The Provider |
FELTES |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3 HERON RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MYSTIC |
Zip Code Of The Provider |
063553253 |
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 |
9 |
Number Of Services |
2196 |
Number Of Medicare Beneficiaries |
590 |
Total Submitted Charge Amount |
344440 |
Total Medicare Allowed Amount |
186357.54 |
Total Medicare Payment Amount |
142687.04 |
Total Medicare Standardized Payment Amount |
134113.45 |
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 |
9 |
Number Of Medical Services |
2196 |
Number Of Medicare Beneficiaries With Medical Services |
590 |
Total Medical Submitted Charge Amount |
344440 |
Total Medical Medicare Allowed Amount |
186357.54 |
Total Medical Medicare Payment Amount |
142687.04 |
Total Medical Medicare Standardized Payment Amount |
134113.45 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
185 |
Number Of Beneficiaries Age Greater 84 |
228 |
Number Of Female Beneficiaries |
362 |
Number Of Male Beneficiaries |
228 |
Number Of Non Hispanic White Beneficiaries |
510 |
Number Of Black or African American Beneficiaries |
34 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
28 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
234 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
356 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
59 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
50 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
24 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.4213 |