| National Provider Identifier [NPI]: | 1669593125 |
| Last Name Of The Provider | REGAN |
| First Name Of The Provider | ANDREA |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 527 FERRY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARLOTTE |
| Zip Code Of The Provider | 054459555 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 1522 |
| Number Of Medicare Beneficiaries | 319 |
| Total Submitted Charge Amount | 145543.47 |
| Total Medicare Allowed Amount | 86906.38 |
| Total Medicare Payment Amount | 64642.55 |
| Total Medicare Standardized Payment Amount | 65405.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 100 |
| Number Of Medicare Beneficiaries With Drug Services | 96 |
| Total Drug Submitted ChargeAmount | 4057.03 |
| Total Drug Medicare AllowedAmount | 1936.4 |
| Total Drug Medicare PaymentAmount | 1890.15 |
| Total Drug Medicare Standardized Payment Amount | 1890.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 1422 |
| Number Of Medicare Beneficiaries With Medical Services | 319 |
| Total Medical Submitted Charge Amount | 141486.44 |
| Total Medical Medicare Allowed Amount | 84969.98 |
| Total Medical Medicare Payment Amount | 62752.4 |
| Total Medical Medicare Standardized Payment Amount | 63515.22 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 143 |
| Number Of Beneficiaries Age 75 to 84 | 94 |
| Number Of Beneficiaries Age Greater 84 | 51 |
| Number Of Female Beneficiaries | 194 |
| Number Of Male Beneficiaries | 125 |
| Number Of Non Hispanic White Beneficiaries | 302 |
| 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 | 265 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 21 |
| Percent Of With Hypertension | 35 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8217 |