National Provider Identifier [NPI]: |
1427215920 |
Last Name Of The Provider |
BROUGH |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1132 BISHOP ST STE 1110 |
Street Address 2 Of The Provider |
|
City Of The Provider |
HONOLULU |
Zip Code Of The Provider |
968132829 |
State Code Of The Provider |
HI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
55 |
Number Of Services |
1103 |
Number Of Medicare Beneficiaries |
164 |
Total Submitted Charge Amount |
200380.95 |
Total Medicare Allowed Amount |
54429.69 |
Total Medicare Payment Amount |
38310.75 |
Total Medicare Standardized Payment Amount |
38323.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
236 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
5640.05 |
Total Drug Medicare AllowedAmount |
2269.87 |
Total Drug Medicare PaymentAmount |
1776.04 |
Total Drug Medicare Standardized Payment Amount |
1776.04 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
48 |
Number Of Medical Services |
867 |
Number Of Medicare Beneficiaries With Medical Services |
163 |
Total Medical Submitted Charge Amount |
194740.9 |
Total Medical Medicare Allowed Amount |
52159.82 |
Total Medical Medicare Payment Amount |
36534.71 |
Total Medical Medicare Standardized Payment Amount |
36547.17 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
81 |
Number Of Beneficiaries Age 75 to 84 |
48 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
107 |
Number Of Male Beneficiaries |
57 |
Number Of Non Hispanic White Beneficiaries |
137 |
Number Of Black or African American Beneficiaries |
16 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
23 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
35 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0961 |