| National Provider Identifier [NPI]: | 1013230515 |
| Last Name Of The Provider | RAFTER |
| First Name Of The Provider | MARY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 66 WATER ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | WISCASSET |
| Zip Code Of The Provider | 045784133 |
| State Code Of The Provider | ME |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 794 |
| Number Of Medicare Beneficiaries | 92 |
| Total Submitted Charge Amount | 34435.2 |
| Total Medicare Allowed Amount | 19598.31 |
| Total Medicare Payment Amount | 16456.24 |
| Total Medicare Standardized Payment Amount | 19311.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 32 |
| Number Of Medicare Beneficiaries With Drug Services | 29 |
| Total Drug Submitted ChargeAmount | 947.5 |
| Total Drug Medicare AllowedAmount | 778.19 |
| Total Drug Medicare PaymentAmount | 761.86 |
| Total Drug Medicare Standardized Payment Amount | 761.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 762 |
| Number Of Medicare Beneficiaries With Medical Services | 92 |
| Total Medical Submitted Charge Amount | 33487.7 |
| Total Medical Medicare Allowed Amount | 18820.12 |
| Total Medical Medicare Payment Amount | 15694.38 |
| Total Medical Medicare Standardized Payment Amount | 18549.2 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 34 |
| Number Of Beneficiaries Age 75 to 84 | 17 |
| Number Of Beneficiaries Age Greater 84 | 11 |
| Number Of Female Beneficiaries | 59 |
| Number Of Male Beneficiaries | 33 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 57 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 15 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9314 |