National Provider Identifier [NPI]: |
1861461923 |
Last Name Of The Provider |
BROOKS |
First Name Of The Provider |
JOHN |
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 |
110 HOSPITAL DR |
Street Address 2 Of The Provider |
SUITE 111 |
City Of The Provider |
PRINCE FREDERICK |
Zip Code Of The Provider |
20678 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
964 |
Number Of Medicare Beneficiaries |
214 |
Total Submitted Charge Amount |
65255 |
Total Medicare Allowed Amount |
51122.45 |
Total Medicare Payment Amount |
34787.14 |
Total Medicare Standardized Payment Amount |
35120.49 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
115 |
Number Of Medicare Beneficiaries With Drug Services |
104 |
Total Drug Submitted ChargeAmount |
5685 |
Total Drug Medicare AllowedAmount |
3529.52 |
Total Drug Medicare PaymentAmount |
3425.65 |
Total Drug Medicare Standardized Payment Amount |
3425.65 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
849 |
Number Of Medicare Beneficiaries With Medical Services |
214 |
Total Medical Submitted Charge Amount |
59570 |
Total Medical Medicare Allowed Amount |
47592.93 |
Total Medical Medicare Payment Amount |
31361.49 |
Total Medical Medicare Standardized Payment Amount |
31694.84 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
150 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
101 |
Number Of Male Beneficiaries |
113 |
Number Of Non Hispanic White Beneficiaries |
182 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7593 |