| National Provider Identifier [NPI]: | 1033175971 |
| Last Name Of The Provider | RAPH |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 20 HARTFORD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOULTON |
| Zip Code Of The Provider | 047301891 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 214 |
| Number Of Medicare Beneficiaries | 113 |
| Total Submitted Charge Amount | 24464 |
| Total Medicare Allowed Amount | 10645.58 |
| Total Medicare Payment Amount | 8501.37 |
| Total Medicare Standardized Payment Amount | 9144.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 13 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 234 |
| Total Drug Medicare AllowedAmount | 156.52 |
| Total Drug Medicare PaymentAmount | 153.4 |
| Total Drug Medicare Standardized Payment Amount | 153.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 9 |
| Number Of Medical Services | 201 |
| Number Of Medicare Beneficiaries With Medical Services | 113 |
| Total Medical Submitted Charge Amount | 24230 |
| Total Medical Medicare Allowed Amount | 10489.06 |
| Total Medical Medicare Payment Amount | 8347.97 |
| Total Medical Medicare Standardized Payment Amount | 8990.95 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 14 |
| Number Of Beneficiaries Age 65 to 74 | 43 |
| Number Of Beneficiaries Age 75 to 84 | 42 |
| Number Of Beneficiaries Age Greater 84 | 14 |
| Number Of Female Beneficiaries | 58 |
| Number Of Male Beneficiaries | 55 |
| 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 | 89 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 24 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 11 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 13 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8169 |