National Provider Identifier [NPI]: |
1386604924 |
Last Name Of The Provider |
BROOKENS |
First Name Of The Provider |
TODD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2142 N COVE BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
TOLEDO |
Zip Code Of The Provider |
436063895 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
35 |
Number Of Services |
1343 |
Number Of Medicare Beneficiaries |
838 |
Total Submitted Charge Amount |
428242.4 |
Total Medicare Allowed Amount |
137621.45 |
Total Medicare Payment Amount |
104205.18 |
Total Medicare Standardized Payment Amount |
105227.11 |
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 |
35 |
Number Of Medical Services |
1343 |
Number Of Medicare Beneficiaries With Medical Services |
838 |
Total Medical Submitted Charge Amount |
428242.4 |
Total Medical Medicare Allowed Amount |
137621.45 |
Total Medical Medicare Payment Amount |
104205.18 |
Total Medical Medicare Standardized Payment Amount |
105227.11 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
286 |
Number Of Beneficiaries Age 65 to 74 |
225 |
Number Of Beneficiaries Age 75 to 84 |
189 |
Number Of Beneficiaries Age Greater 84 |
138 |
Number Of Female Beneficiaries |
468 |
Number Of Male Beneficiaries |
370 |
Number Of Non Hispanic White Beneficiaries |
633 |
Number Of Black or African American Beneficiaries |
185 |
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 |
477 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
361 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.0371 |