National Provider Identifier [NPI]: |
1114996444 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
THOMAS |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5735 MEEKER RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GREENVILLE |
Zip Code Of The Provider |
45331 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
885 |
Number Of Medicare Beneficiaries |
298 |
Total Submitted Charge Amount |
53051 |
Total Medicare Allowed Amount |
24343.1 |
Total Medicare Payment Amount |
18989.43 |
Total Medicare Standardized Payment Amount |
19408.18 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
885 |
Number Of Medicare Beneficiaries With Medical Services |
298 |
Total Medical Submitted Charge Amount |
53051 |
Total Medical Medicare Allowed Amount |
24343.1 |
Total Medical Medicare Payment Amount |
18989.43 |
Total Medical Medicare Standardized Payment Amount |
19408.18 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
94 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
192 |
Number Of Male Beneficiaries |
106 |
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 |
233 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
65 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0985 |