National Provider Identifier [NPI]: |
1366745390 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
BRIDGET |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2865 NETHERTON DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631364674 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
112 |
Number Of Medicare Beneficiaries |
66 |
Total Submitted Charge Amount |
4584.67 |
Total Medicare Allowed Amount |
3944.52 |
Total Medicare Payment Amount |
3219.18 |
Total Medicare Standardized Payment Amount |
3933.43 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
33 |
Number Of Medicare Beneficiaries With Drug Services |
33 |
Total Drug Submitted ChargeAmount |
1106.67 |
Total Drug Medicare AllowedAmount |
916.04 |
Total Drug Medicare PaymentAmount |
897.67 |
Total Drug Medicare Standardized Payment Amount |
897.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
79 |
Number Of Medicare Beneficiaries With Medical Services |
66 |
Total Medical Submitted Charge Amount |
3478 |
Total Medical Medicare Allowed Amount |
3028.48 |
Total Medical Medicare Payment Amount |
2321.51 |
Total Medical Medicare Standardized Payment Amount |
3035.76 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
11 |
Number Of Beneficiaries Age 65 to 74 |
26 |
Number Of Beneficiaries Age 75 to 84 |
18 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
39 |
Number Of Male Beneficiaries |
27 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
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 |
|
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
29 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
48 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0025 |