National Provider Identifier [NPI]: |
1104806314 |
Last Name Of The Provider |
SOROFF |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
60 HIGH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LEWISTON |
Zip Code Of The Provider |
042407616 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
1909 |
Number Of Medicare Beneficiaries |
1072 |
Total Submitted Charge Amount |
348509 |
Total Medicare Allowed Amount |
115972.5 |
Total Medicare Payment Amount |
89054.48 |
Total Medicare Standardized Payment Amount |
94883.1 |
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 |
74 |
Number Of Medical Services |
1909 |
Number Of Medicare Beneficiaries With Medical Services |
1072 |
Total Medical Submitted Charge Amount |
348509 |
Total Medical Medicare Allowed Amount |
115972.5 |
Total Medical Medicare Payment Amount |
89054.48 |
Total Medical Medicare Standardized Payment Amount |
94883.1 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
213 |
Number Of Beneficiaries Age 65 to 74 |
325 |
Number Of Beneficiaries Age 75 to 84 |
371 |
Number Of Beneficiaries Age Greater 84 |
163 |
Number Of Female Beneficiaries |
580 |
Number Of Male Beneficiaries |
492 |
Number Of Non Hispanic White Beneficiaries |
1048 |
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 |
550 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
522 |
Percent Of With Atrial Fibrillation |
33 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7233 |