| National Provider Identifier [NPI]: | 1942279617 |
| Last Name Of The Provider | DOBIESKI |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 84 MARGINAL WAY |
| Street Address 2 Of The Provider | SUITE 800 |
| City Of The Provider | PORTLAND |
| Zip Code Of The Provider | 04101 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 135 |
| Number Of Services | 4483 |
| Number Of Medicare Beneficiaries | 560 |
| Total Submitted Charge Amount | 338467 |
| Total Medicare Allowed Amount | 163650.56 |
| Total Medicare Payment Amount | 120026.65 |
| Total Medicare Standardized Payment Amount | 121742.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 12 |
| Number Of Drug Services | 434 |
| Number Of Medicare Beneficiaries With Drug Services | 204 |
| Total Drug Submitted ChargeAmount | 11490 |
| Total Drug Medicare AllowedAmount | 8313.83 |
| Total Drug Medicare PaymentAmount | 8068.17 |
| Total Drug Medicare Standardized Payment Amount | 8068.17 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 123 |
| Number Of Medical Services | 4049 |
| Number Of Medicare Beneficiaries With Medical Services | 560 |
| Total Medical Submitted Charge Amount | 326977 |
| Total Medical Medicare Allowed Amount | 155336.73 |
| Total Medical Medicare Payment Amount | 111958.48 |
| Total Medical Medicare Standardized Payment Amount | 113674.34 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 247 |
| Number Of Beneficiaries Age 75 to 84 | 180 |
| Number Of Beneficiaries Age Greater 84 | 106 |
| Number Of Female Beneficiaries | 282 |
| Number Of Male Beneficiaries | 278 |
| Number Of Non Hispanic White Beneficiaries | 546 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 503 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 49 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9558 |