National Provider Identifier [NPI]: |
1083838239 |
Last Name Of The Provider |
BRANDER |
First Name Of The Provider |
BROOKE |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
DO |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3232 N NORTHHILLS BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
FAYETTEVILLE |
Zip Code Of The Provider |
727034005 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Hematology/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
112 |
Number Of Services |
119169 |
Number Of Medicare Beneficiaries |
350 |
Total Submitted Charge Amount |
3502838 |
Total Medicare Allowed Amount |
1809847.96 |
Total Medicare Payment Amount |
1400964.68 |
Total Medicare Standardized Payment Amount |
1417106.46 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
58 |
Number Of Drug Services |
110050 |
Number Of Medicare Beneficiaries With Drug Services |
109 |
Total Drug Submitted ChargeAmount |
2738203 |
Total Drug Medicare AllowedAmount |
1473988.84 |
Total Drug Medicare PaymentAmount |
1143347.66 |
Total Drug Medicare Standardized Payment Amount |
1143347.66 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
9119 |
Number Of Medicare Beneficiaries With Medical Services |
350 |
Total Medical Submitted Charge Amount |
764635 |
Total Medical Medicare Allowed Amount |
335859.12 |
Total Medical Medicare Payment Amount |
257617.02 |
Total Medical Medicare Standardized Payment Amount |
273758.8 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
156 |
Number Of Beneficiaries Age 75 to 84 |
121 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
214 |
Number Of Male Beneficiaries |
136 |
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 |
301 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
49 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
56 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
28 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6742 |