National Provider Identifier [NPI]: |
1033200688 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
ELISABETH |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
13330 BLOOMFIELD AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORWALK |
Zip Code Of The Provider |
906503251 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
43 |
Number Of Services |
661 |
Number Of Medicare Beneficiaries |
121 |
Total Submitted Charge Amount |
63284 |
Total Medicare Allowed Amount |
34988 |
Total Medicare Payment Amount |
23851.25 |
Total Medicare Standardized Payment Amount |
22049.94 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
91 |
Number Of Medicare Beneficiaries With Drug Services |
43 |
Total Drug Submitted ChargeAmount |
4274 |
Total Drug Medicare AllowedAmount |
2027.63 |
Total Drug Medicare PaymentAmount |
1967.1 |
Total Drug Medicare Standardized Payment Amount |
1967.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
570 |
Number Of Medicare Beneficiaries With Medical Services |
121 |
Total Medical Submitted Charge Amount |
59010 |
Total Medical Medicare Allowed Amount |
32960.37 |
Total Medical Medicare Payment Amount |
21884.15 |
Total Medical Medicare Standardized Payment Amount |
20082.84 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
41 |
Number Of Beneficiaries Age 75 to 84 |
30 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
88 |
Number Of Male Beneficiaries |
33 |
Number Of Non Hispanic White Beneficiaries |
80 |
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 |
102 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
17 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0999 |