National Provider Identifier [NPI]: |
1568502938 |
Last Name Of The Provider |
BRYANT |
First Name Of The Provider |
DEREK |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
610 W COMMERCE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BRYANT |
Zip Code Of The Provider |
72022 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
78 |
Number Of Services |
6051 |
Number Of Medicare Beneficiaries |
384 |
Total Submitted Charge Amount |
239430 |
Total Medicare Allowed Amount |
135832.7 |
Total Medicare Payment Amount |
94026.66 |
Total Medicare Standardized Payment Amount |
107099.09 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
229 |
Number Of Medicare Beneficiaries With Drug Services |
152 |
Total Drug Submitted ChargeAmount |
5776 |
Total Drug Medicare AllowedAmount |
2640.59 |
Total Drug Medicare PaymentAmount |
2575.03 |
Total Drug Medicare Standardized Payment Amount |
2575.03 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
68 |
Number Of Medical Services |
5822 |
Number Of Medicare Beneficiaries With Medical Services |
384 |
Total Medical Submitted Charge Amount |
233654 |
Total Medical Medicare Allowed Amount |
133192.11 |
Total Medical Medicare Payment Amount |
91451.63 |
Total Medical Medicare Standardized Payment Amount |
104524.06 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
190 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
225 |
Number Of Male Beneficiaries |
159 |
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 |
363 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
55 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9569 |