| National Provider Identifier [NPI]: | 1487715660 |
| Last Name Of The Provider | BROWN |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 659 BOULEVARD |
| Street Address 2 Of The Provider | UNION HOSPITAL DEPARTMENT OF PATHOLOGY |
| City Of The Provider | DOVER |
| Zip Code Of The Provider | 44622 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pathology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 19 |
| Number Of Services | 1484 |
| Number Of Medicare Beneficiaries | 677 |
| Total Submitted Charge Amount | 189010 |
| Total Medicare Allowed Amount | 49922.37 |
| Total Medicare Payment Amount | 38875.72 |
| Total Medicare Standardized Payment Amount | 31232.34 |
| 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 | 19 |
| Number Of Medical Services | 1484 |
| Number Of Medicare Beneficiaries With Medical Services | 677 |
| Total Medical Submitted Charge Amount | 189010 |
| Total Medical Medicare Allowed Amount | 49922.37 |
| Total Medical Medicare Payment Amount | 38875.72 |
| Total Medical Medicare Standardized Payment Amount | 31232.34 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 111 |
| Number Of Beneficiaries Age 65 to 74 | 254 |
| Number Of Beneficiaries Age 75 to 84 | 204 |
| Number Of Beneficiaries Age Greater 84 | 108 |
| Number Of Female Beneficiaries | 381 |
| Number Of Male Beneficiaries | 296 |
| Number Of Non Hispanic White Beneficiaries | 662 |
| 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 | 500 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 177 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.6428 |