National Provider Identifier [NPI]: |
1649226317 |
Last Name Of The Provider |
LEBRUN |
First Name Of The Provider |
CHRISTOPHER |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
129 N BROOKMOORE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBUS |
Zip Code Of The Provider |
397052024 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nephrology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
28 |
Number Of Services |
25948 |
Number Of Medicare Beneficiaries |
604 |
Total Submitted Charge Amount |
1974075.46 |
Total Medicare Allowed Amount |
722359.83 |
Total Medicare Payment Amount |
551390.48 |
Total Medicare Standardized Payment Amount |
584453.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
22210 |
Number Of Medicare Beneficiaries With Drug Services |
60 |
Total Drug Submitted ChargeAmount |
166300 |
Total Drug Medicare AllowedAmount |
61305.32 |
Total Drug Medicare PaymentAmount |
47438.56 |
Total Drug Medicare Standardized Payment Amount |
47438.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
3738 |
Number Of Medicare Beneficiaries With Medical Services |
604 |
Total Medical Submitted Charge Amount |
1807775.46 |
Total Medical Medicare Allowed Amount |
661054.51 |
Total Medical Medicare Payment Amount |
503951.92 |
Total Medical Medicare Standardized Payment Amount |
537014.96 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
254 |
Number Of Beneficiaries Age 65 to 74 |
188 |
Number Of Beneficiaries Age 75 to 84 |
121 |
Number Of Beneficiaries Age Greater 84 |
41 |
Number Of Female Beneficiaries |
303 |
Number Of Male Beneficiaries |
301 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
381 |
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 |
293 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
311 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
62 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
2 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
4.3137 |