| National Provider Identifier [NPI]: | 1598708315 |
| Last Name Of The Provider | HATTAN |
| First Name Of The Provider | THOMAS |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 76 HIGH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEWISTON |
| Zip Code Of The Provider | 042407649 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Geriatric Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 35 |
| Number Of Services | 1030 |
| Number Of Medicare Beneficiaries | 432 |
| Total Submitted Charge Amount | 221142.75 |
| Total Medicare Allowed Amount | 108570.78 |
| Total Medicare Payment Amount | 83217.99 |
| Total Medicare Standardized Payment Amount | 86906.05 |
| 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 | 35 |
| Number Of Medical Services | 1030 |
| Number Of Medicare Beneficiaries With Medical Services | 432 |
| Total Medical Submitted Charge Amount | 221142.75 |
| Total Medical Medicare Allowed Amount | 108570.78 |
| Total Medical Medicare Payment Amount | 83217.99 |
| Total Medical Medicare Standardized Payment Amount | 86906.05 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 73 |
| Number Of Beneficiaries Age 65 to 74 | 85 |
| Number Of Beneficiaries Age 75 to 84 | 116 |
| Number Of Beneficiaries Age Greater 84 | 158 |
| Number Of Female Beneficiaries | 282 |
| Number Of Male Beneficiaries | 150 |
| Number Of Non Hispanic White Beneficiaries | 419 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 124 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 308 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 48 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 2.0091 |