National Provider Identifier [NPI]: |
1972663300 |
Last Name Of The Provider |
BENNETT |
First Name Of The Provider |
WILLIAM |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
325 KENNEDY MEMORIAL DR # C |
Street Address 2 Of The Provider |
|
City Of The Provider |
WATERVILLE |
Zip Code Of The Provider |
049014517 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
47 |
Number Of Services |
1499 |
Number Of Medicare Beneficiaries |
294 |
Total Submitted Charge Amount |
181779 |
Total Medicare Allowed Amount |
102293.57 |
Total Medicare Payment Amount |
75846.87 |
Total Medicare Standardized Payment Amount |
82464.76 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
164 |
Number Of Medicare Beneficiaries With Drug Services |
134 |
Total Drug Submitted ChargeAmount |
8915 |
Total Drug Medicare AllowedAmount |
5079.5 |
Total Drug Medicare PaymentAmount |
4931.82 |
Total Drug Medicare Standardized Payment Amount |
4931.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
39 |
Number Of Medical Services |
1335 |
Number Of Medicare Beneficiaries With Medical Services |
293 |
Total Medical Submitted Charge Amount |
172864 |
Total Medical Medicare Allowed Amount |
97214.07 |
Total Medical Medicare Payment Amount |
70915.05 |
Total Medical Medicare Standardized Payment Amount |
77532.94 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
46 |
Number Of Beneficiaries Age 65 to 74 |
103 |
Number Of Beneficiaries Age 75 to 84 |
98 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
148 |
Number Of Male Beneficiaries |
146 |
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 |
179 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
|
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
52 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0391 |