National Provider Identifier [NPI]: |
1780605212 |
Last Name Of The Provider |
BRIGHAM |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12990 MANCHESTER RD |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
ST LOUIS |
Zip Code Of The Provider |
631311804 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
1615 |
Number Of Medicare Beneficiaries |
723 |
Total Submitted Charge Amount |
474776 |
Total Medicare Allowed Amount |
210475.88 |
Total Medicare Payment Amount |
150495.71 |
Total Medicare Standardized Payment Amount |
150586.87 |
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 |
38 |
Number Of Medical Services |
1615 |
Number Of Medicare Beneficiaries With Medical Services |
723 |
Total Medical Submitted Charge Amount |
474776 |
Total Medical Medicare Allowed Amount |
210475.88 |
Total Medical Medicare Payment Amount |
150495.71 |
Total Medical Medicare Standardized Payment Amount |
150586.87 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
261 |
Number Of Beneficiaries Age 75 to 84 |
307 |
Number Of Beneficiaries Age Greater 84 |
136 |
Number Of Female Beneficiaries |
437 |
Number Of Male Beneficiaries |
286 |
Number Of Non Hispanic White Beneficiaries |
701 |
Number Of Black or African American Beneficiaries |
|
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 |
705 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
18 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.009 |