National Provider Identifier [NPI]: |
1326296658 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
CHARLENE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
APN |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2707 BROWNS LN |
Street Address 2 Of The Provider |
|
City Of The Provider |
JONESBORO |
Zip Code Of The Provider |
724017213 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
3 |
Number Of Services |
668 |
Number Of Medicare Beneficiaries |
234 |
Total Submitted Charge Amount |
40912.04 |
Total Medicare Allowed Amount |
34784.64 |
Total Medicare Payment Amount |
21036.86 |
Total Medicare Standardized Payment Amount |
29170.08 |
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 |
3 |
Number Of Medical Services |
668 |
Number Of Medicare Beneficiaries With Medical Services |
234 |
Total Medical Submitted Charge Amount |
40912.04 |
Total Medical Medicare Allowed Amount |
34784.64 |
Total Medical Medicare Payment Amount |
21036.86 |
Total Medical Medicare Standardized Payment Amount |
29170.08 |
Average Age Of Beneficiaries |
49 |
Number Of Beneficiaries Age Less65 |
199 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
127 |
Number Of Male Beneficiaries |
107 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
119 |
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 |
37 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
197 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
5 |
Percent Of With Chronic Kidney Disease |
7 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
21 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
14 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
62 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0244 |