National Provider Identifier [NPI]: |
1194861849 |
Last Name Of The Provider |
BRUNO |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
PA C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1790 N STONEBRIDGE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MCKINNEY |
Zip Code Of The Provider |
75071 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
1973 |
Number Of Medicare Beneficiaries |
400 |
Total Submitted Charge Amount |
210315 |
Total Medicare Allowed Amount |
77971.49 |
Total Medicare Payment Amount |
58219.8 |
Total Medicare Standardized Payment Amount |
69850.05 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
117 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
3291 |
Total Drug Medicare AllowedAmount |
447.88 |
Total Drug Medicare PaymentAmount |
337.12 |
Total Drug Medicare Standardized Payment Amount |
337.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
32 |
Number Of Medical Services |
1856 |
Number Of Medicare Beneficiaries With Medical Services |
400 |
Total Medical Submitted Charge Amount |
207024 |
Total Medical Medicare Allowed Amount |
77523.61 |
Total Medical Medicare Payment Amount |
57882.68 |
Total Medical Medicare Standardized Payment Amount |
69512.93 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
14 |
Number Of Beneficiaries Age 65 to 74 |
238 |
Number Of Beneficiaries Age 75 to 84 |
110 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
195 |
Number Of Male Beneficiaries |
205 |
Number Of Non Hispanic White Beneficiaries |
379 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
385 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
15 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9504 |