National Provider Identifier [NPI]: |
1033281712 |
Last Name Of The Provider |
QUINN |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
O |
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 |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
192 |
Number Of Services |
5530 |
Number Of Medicare Beneficiaries |
3519 |
Total Submitted Charge Amount |
993998 |
Total Medicare Allowed Amount |
191964.62 |
Total Medicare Payment Amount |
144615.03 |
Total Medicare Standardized Payment Amount |
149256.58 |
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 |
192 |
Number Of Medical Services |
5530 |
Number Of Medicare Beneficiaries With Medical Services |
3519 |
Total Medical Submitted Charge Amount |
993998 |
Total Medical Medicare Allowed Amount |
191964.62 |
Total Medical Medicare Payment Amount |
144615.03 |
Total Medical Medicare Standardized Payment Amount |
149256.58 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
652 |
Number Of Beneficiaries Age 65 to 74 |
1271 |
Number Of Beneficiaries Age 75 to 84 |
1089 |
Number Of Beneficiaries Age Greater 84 |
507 |
Number Of Female Beneficiaries |
1961 |
Number Of Male Beneficiaries |
1558 |
Number Of Non Hispanic White Beneficiaries |
3406 |
Number Of Black or African American Beneficiaries |
26 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
45 |
Number Of Beneficiaries With Medicare Only Entitlement |
2273 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1246 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.622 |