National Provider Identifier [NPI]: |
1235216094 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
BENJAMIN |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
149 NORTH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WATERVILLE |
Zip Code Of The Provider |
049014974 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
1103 |
Number Of Medicare Beneficiaries |
373 |
Total Submitted Charge Amount |
203337 |
Total Medicare Allowed Amount |
102341.21 |
Total Medicare Payment Amount |
79917.21 |
Total Medicare Standardized Payment Amount |
83056.9 |
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 |
18 |
Number Of Medical Services |
1103 |
Number Of Medicare Beneficiaries With Medical Services |
373 |
Total Medical Submitted Charge Amount |
203337 |
Total Medical Medicare Allowed Amount |
102341.21 |
Total Medical Medicare Payment Amount |
79917.21 |
Total Medical Medicare Standardized Payment Amount |
83056.9 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
72 |
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
107 |
Number Of Beneficiaries Age Greater 84 |
88 |
Number Of Female Beneficiaries |
207 |
Number Of Male Beneficiaries |
166 |
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 |
167 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
206 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
46 |
Percent Of With Chronic Kidney Disease |
48 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
47 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.0217 |