National Provider Identifier [NPI]: |
1346439767 |
Last Name Of The Provider |
KIRKPATRICK |
First Name Of The Provider |
SALLY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
498 ESSEX ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
BANGOR |
Zip Code Of The Provider |
044013990 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
466 |
Number Of Medicare Beneficiaries |
314 |
Total Submitted Charge Amount |
99181.1 |
Total Medicare Allowed Amount |
42394.55 |
Total Medicare Payment Amount |
29860.66 |
Total Medicare Standardized Payment Amount |
31658.46 |
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 |
15 |
Number Of Medical Services |
466 |
Number Of Medicare Beneficiaries With Medical Services |
314 |
Total Medical Submitted Charge Amount |
99181.1 |
Total Medical Medicare Allowed Amount |
42394.55 |
Total Medical Medicare Payment Amount |
29860.66 |
Total Medical Medicare Standardized Payment Amount |
31658.46 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
136 |
Number Of Beneficiaries Age 65 to 74 |
77 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
202 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
301 |
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 |
152 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
162 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
1.3034 |