National Provider Identifier [NPI]: |
1306894589 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
BILLY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5 SEVERANCE CIR |
Street Address 2 Of The Provider |
#304 |
City Of The Provider |
CLEVELAND HEIGHTS |
Zip Code Of The Provider |
441181566 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
6 |
Number Of Services |
301 |
Number Of Medicare Beneficiaries |
171 |
Total Submitted Charge Amount |
64760 |
Total Medicare Allowed Amount |
24712.11 |
Total Medicare Payment Amount |
12893.66 |
Total Medicare Standardized Payment Amount |
13235.24 |
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 |
6 |
Number Of Medical Services |
301 |
Number Of Medicare Beneficiaries With Medical Services |
171 |
Total Medical Submitted Charge Amount |
64760 |
Total Medical Medicare Allowed Amount |
24712.11 |
Total Medical Medicare Payment Amount |
12893.66 |
Total Medical Medicare Standardized Payment Amount |
13235.24 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
61 |
Number Of Beneficiaries Age 65 to 74 |
48 |
Number Of Beneficiaries Age 75 to 84 |
50 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
94 |
Number Of Male Beneficiaries |
77 |
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 |
80 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
91 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.3549 |