National Provider Identifier [NPI]: |
1821037128 |
Last Name Of The Provider |
PATRICK |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8601 EASTHAVEN CT |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW PORT RICHEY |
Zip Code Of The Provider |
346555214 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
571 |
Number Of Medicare Beneficiaries |
272 |
Total Submitted Charge Amount |
68899 |
Total Medicare Allowed Amount |
36249.17 |
Total Medicare Payment Amount |
25971.25 |
Total Medicare Standardized Payment Amount |
26035.76 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
27 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
655 |
Total Drug Medicare AllowedAmount |
64.43 |
Total Drug Medicare PaymentAmount |
55.25 |
Total Drug Medicare Standardized Payment Amount |
55.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
544 |
Number Of Medicare Beneficiaries With Medical Services |
272 |
Total Medical Submitted Charge Amount |
68244 |
Total Medical Medicare Allowed Amount |
36184.74 |
Total Medical Medicare Payment Amount |
25916 |
Total Medical Medicare Standardized Payment Amount |
25980.51 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
67 |
Number Of Beneficiaries Age 65 to 74 |
118 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
142 |
Number Of Male Beneficiaries |
130 |
Number Of Non Hispanic White Beneficiaries |
240 |
Number Of Black or African American Beneficiaries |
18 |
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 |
196 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
76 |
Percent Of With Atrial Fibrillation |
4 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
30 |
Percent Of With Hypertension |
46 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
11 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1617 |