National Provider Identifier [NPI]: |
1609819978 |
Last Name Of The Provider |
SESSELBERG |
First Name Of The Provider |
HENRY |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
96 CAMPUS DRIVE |
Street Address 2 Of The Provider |
SUITE 1 |
City Of The Provider |
SCARBOROUGH |
Zip Code Of The Provider |
04074 |
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 |
83 |
Number Of Services |
3424 |
Number Of Medicare Beneficiaries |
1788 |
Total Submitted Charge Amount |
425283.5 |
Total Medicare Allowed Amount |
217052.72 |
Total Medicare Payment Amount |
162712.05 |
Total Medicare Standardized Payment Amount |
168949.17 |
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 |
83 |
Number Of Medical Services |
3424 |
Number Of Medicare Beneficiaries With Medical Services |
1788 |
Total Medical Submitted Charge Amount |
425283.5 |
Total Medical Medicare Allowed Amount |
217052.72 |
Total Medical Medicare Payment Amount |
162712.05 |
Total Medical Medicare Standardized Payment Amount |
168949.17 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
225 |
Number Of Beneficiaries Age 65 to 74 |
528 |
Number Of Beneficiaries Age 75 to 84 |
617 |
Number Of Beneficiaries Age Greater 84 |
418 |
Number Of Female Beneficiaries |
822 |
Number Of Male Beneficiaries |
966 |
Number Of Non Hispanic White Beneficiaries |
1744 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
12 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
1216 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
572 |
Percent Of With Atrial Fibrillation |
47 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
52 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.8269 |