National Provider Identifier [NPI]: |
1588667158 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1339 EAST ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
GRAHAM |
Zip Code Of The Provider |
764504228 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
161 |
Number Of Services |
13716 |
Number Of Medicare Beneficiaries |
790 |
Total Submitted Charge Amount |
1240467 |
Total Medicare Allowed Amount |
441517.02 |
Total Medicare Payment Amount |
343600.45 |
Total Medicare Standardized Payment Amount |
379214.39 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
18 |
Number Of Drug Services |
1180 |
Number Of Medicare Beneficiaries With Drug Services |
407 |
Total Drug Submitted ChargeAmount |
31003 |
Total Drug Medicare AllowedAmount |
11803.63 |
Total Drug Medicare PaymentAmount |
9949.14 |
Total Drug Medicare Standardized Payment Amount |
9949.14 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
143 |
Number Of Medical Services |
12536 |
Number Of Medicare Beneficiaries With Medical Services |
790 |
Total Medical Submitted Charge Amount |
1209464 |
Total Medical Medicare Allowed Amount |
429713.39 |
Total Medical Medicare Payment Amount |
333651.31 |
Total Medical Medicare Standardized Payment Amount |
369265.25 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
53 |
Number Of Beneficiaries Age 65 to 74 |
347 |
Number Of Beneficiaries Age 75 to 84 |
271 |
Number Of Beneficiaries Age Greater 84 |
119 |
Number Of Female Beneficiaries |
402 |
Number Of Male Beneficiaries |
388 |
Number Of Non Hispanic White Beneficiaries |
763 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
726 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
64 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0025 |