National Provider Identifier [NPI]: |
1598057549 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
CHRISTINA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
D.O |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
617 OLD SYMSONIA RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BENTON |
Zip Code Of The Provider |
420255042 |
State Code Of The Provider |
KY |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
56 |
Number Of Services |
1418 |
Number Of Medicare Beneficiaries |
322 |
Total Submitted Charge Amount |
140708.84 |
Total Medicare Allowed Amount |
110099.69 |
Total Medicare Payment Amount |
78763.12 |
Total Medicare Standardized Payment Amount |
85191.68 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
61 |
Number Of Medicare Beneficiaries With Drug Services |
45 |
Total Drug Submitted ChargeAmount |
766.84 |
Total Drug Medicare AllowedAmount |
734.47 |
Total Drug Medicare PaymentAmount |
712.57 |
Total Drug Medicare Standardized Payment Amount |
712.57 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
1357 |
Number Of Medicare Beneficiaries With Medical Services |
322 |
Total Medical Submitted Charge Amount |
139942 |
Total Medical Medicare Allowed Amount |
109365.22 |
Total Medical Medicare Payment Amount |
78050.55 |
Total Medical Medicare Standardized Payment Amount |
84479.11 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
57 |
Number Of Beneficiaries Age 65 to 74 |
116 |
Number Of Beneficiaries Age 75 to 84 |
94 |
Number Of Beneficiaries Age Greater 84 |
55 |
Number Of Female Beneficiaries |
197 |
Number Of Male Beneficiaries |
125 |
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 |
251 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2163 |