National Provider Identifier [NPI]: |
1679645857 |
Last Name Of The Provider |
RINTEL |
First Name Of The Provider |
THEODOR |
Middle Initial Of The Provider |
D |
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 |
77 |
Number Of Services |
555 |
Number Of Medicare Beneficiaries |
488 |
Total Submitted Charge Amount |
759736 |
Total Medicare Allowed Amount |
88336.29 |
Total Medicare Payment Amount |
67739.01 |
Total Medicare Standardized Payment Amount |
70621.13 |
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 |
77 |
Number Of Medical Services |
555 |
Number Of Medicare Beneficiaries With Medical Services |
488 |
Total Medical Submitted Charge Amount |
759736 |
Total Medical Medicare Allowed Amount |
88336.29 |
Total Medical Medicare Payment Amount |
67739.01 |
Total Medical Medicare Standardized Payment Amount |
70621.13 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
89 |
Number Of Beneficiaries Age 65 to 74 |
199 |
Number Of Beneficiaries Age 75 to 84 |
153 |
Number Of Beneficiaries Age Greater 84 |
47 |
Number Of Female Beneficiaries |
274 |
Number Of Male Beneficiaries |
214 |
Number Of Non Hispanic White Beneficiaries |
462 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
327 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
161 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2618 |