| National Provider Identifier [NPI]: | 1710969233 |
| Last Name Of The Provider | BROWN |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 55 FRUIT STREET |
| Street Address 2 Of The Provider | WHT 130 |
| City Of The Provider | BOSTON |
| Zip Code Of The Provider | 021142696 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 7 |
| Number Of Services | 617 |
| Number Of Medicare Beneficiaries | 179 |
| Total Submitted Charge Amount | 95745 |
| Total Medicare Allowed Amount | 54219.18 |
| Total Medicare Payment Amount | 42002.65 |
| Total Medicare Standardized Payment Amount | 41023.59 |
| 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 | 7 |
| Number Of Medical Services | 617 |
| Number Of Medicare Beneficiaries With Medical Services | 179 |
| Total Medical Submitted Charge Amount | 95745 |
| Total Medical Medicare Allowed Amount | 54219.18 |
| Total Medical Medicare Payment Amount | 42002.65 |
| Total Medical Medicare Standardized Payment Amount | 41023.59 |
| Average Age Of Beneficiaries | 52 |
| Number Of Beneficiaries Age Less65 | 151 |
| Number Of Beneficiaries Age 65 to 74 | 17 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 78 |
| Number Of Male Beneficiaries | 101 |
| Number Of Non Hispanic White Beneficiaries | 146 |
| Number Of Black or African American Beneficiaries | 19 |
| 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 | 28 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 151 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 37 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 24 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 53 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3938 |