National Provider Identifier [NPI]: |
1669492211 |
Last Name Of The Provider |
MORRISON |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
22 BRAMHALL ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
PORTLAND |
Zip Code Of The Provider |
041023134 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
448 |
Number Of Medicare Beneficiaries |
370 |
Total Submitted Charge Amount |
543239 |
Total Medicare Allowed Amount |
56143.54 |
Total Medicare Payment Amount |
43391.24 |
Total Medicare Standardized Payment Amount |
45174.82 |
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 |
74 |
Number Of Medical Services |
448 |
Number Of Medicare Beneficiaries With Medical Services |
370 |
Total Medical Submitted Charge Amount |
543239 |
Total Medical Medicare Allowed Amount |
56143.54 |
Total Medical Medicare Payment Amount |
43391.24 |
Total Medical Medicare Standardized Payment Amount |
45174.82 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
91 |
Number Of Beneficiaries Age 65 to 74 |
160 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
228 |
Number Of Male Beneficiaries |
142 |
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 |
249 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
121 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0998 |