National Provider Identifier [NPI]: |
1649331760 |
Last Name Of The Provider |
LU |
First Name Of The Provider |
BRETT |
Middle Initial Of The Provider |
Y |
Credentials Of The Provider |
MD PHD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1296 KAPIOLANI BLVD APT 3004 |
Street Address 2 Of The Provider |
|
City Of The Provider |
HONOLULU |
Zip Code Of The Provider |
968142886 |
State Code Of The Provider |
HI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
586 |
Number Of Medicare Beneficiaries |
183 |
Total Submitted Charge Amount |
103433.97 |
Total Medicare Allowed Amount |
61343.05 |
Total Medicare Payment Amount |
46798.09 |
Total Medicare Standardized Payment Amount |
45482.05 |
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 |
20 |
Number Of Medical Services |
586 |
Number Of Medicare Beneficiaries With Medical Services |
183 |
Total Medical Submitted Charge Amount |
103433.97 |
Total Medical Medicare Allowed Amount |
61343.05 |
Total Medical Medicare Payment Amount |
46798.09 |
Total Medical Medicare Standardized Payment Amount |
45482.05 |
Average Age Of Beneficiaries |
80 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
117 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
45 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
108 |
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 |
103 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
63 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
30 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
33 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
1.9371 |