National Provider Identifier [NPI]: |
1639197270 |
Last Name Of The Provider |
MILLER |
First Name Of The Provider |
BRENT |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4921 PARKVIEW PL |
Street Address 2 Of The Provider |
5TH FLOOR SUITE C |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631101032 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
4851 |
Number Of Medicare Beneficiaries |
533 |
Total Submitted Charge Amount |
1302257 |
Total Medicare Allowed Amount |
290189.09 |
Total Medicare Payment Amount |
220698.64 |
Total Medicare Standardized Payment Amount |
226748.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
2200 |
Number Of Medicare Beneficiaries With Drug Services |
78 |
Total Drug Submitted ChargeAmount |
32188 |
Total Drug Medicare AllowedAmount |
12239.24 |
Total Drug Medicare PaymentAmount |
10449.35 |
Total Drug Medicare Standardized Payment Amount |
10449.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
36 |
Number Of Medical Services |
2651 |
Number Of Medicare Beneficiaries With Medical Services |
533 |
Total Medical Submitted Charge Amount |
1270069 |
Total Medical Medicare Allowed Amount |
277949.85 |
Total Medical Medicare Payment Amount |
210249.29 |
Total Medical Medicare Standardized Payment Amount |
216298.8 |
Average Age Of Beneficiaries |
58 |
Number Of Beneficiaries Age Less65 |
332 |
Number Of Beneficiaries Age 65 to 74 |
143 |
Number Of Beneficiaries Age 75 to 84 |
43 |
Number Of Beneficiaries Age Greater 84 |
15 |
Number Of Female Beneficiaries |
239 |
Number Of Male Beneficiaries |
294 |
Number Of Non Hispanic White Beneficiaries |
289 |
Number Of Black or African American Beneficiaries |
215 |
Number Of AsianPacific Islander Beneficiaries |
11 |
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 |
318 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
215 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
5.0504 |