National Provider Identifier [NPI]: |
1215924048 |
Last Name Of The Provider |
ANDERSON |
First Name Of The Provider |
BRETT |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4881 SUGAR MAPLE DR |
Street Address 2 Of The Provider |
88 MDG/SGCJ |
City Of The Provider |
WRIGHT PATTERSON AFB |
Zip Code Of The Provider |
454335546 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
275 |
Number Of Medicare Beneficiaries |
253 |
Total Submitted Charge Amount |
263594 |
Total Medicare Allowed Amount |
34363.2 |
Total Medicare Payment Amount |
26852.62 |
Total Medicare Standardized Payment Amount |
27115.58 |
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 |
60 |
Number Of Medical Services |
275 |
Number Of Medicare Beneficiaries With Medical Services |
253 |
Total Medical Submitted Charge Amount |
263594 |
Total Medical Medicare Allowed Amount |
34363.2 |
Total Medical Medicare Payment Amount |
26852.62 |
Total Medical Medicare Standardized Payment Amount |
27115.58 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
144 |
Number Of Male Beneficiaries |
109 |
Number Of Non Hispanic White Beneficiaries |
224 |
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 |
193 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
60 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.636 |