National Provider Identifier [NPI]: |
1144264755 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
GARY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1730 N CORONA ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLORADO SPRINGS |
Zip Code Of The Provider |
809077644 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
238 |
Number Of Medicare Beneficiaries |
84 |
Total Submitted Charge Amount |
40112 |
Total Medicare Allowed Amount |
21467.8 |
Total Medicare Payment Amount |
13160.88 |
Total Medicare Standardized Payment Amount |
13614.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
15 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
506 |
Total Drug Medicare AllowedAmount |
257.08 |
Total Drug Medicare PaymentAmount |
247.56 |
Total Drug Medicare Standardized Payment Amount |
247.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
15 |
Number Of Medical Services |
223 |
Number Of Medicare Beneficiaries With Medical Services |
84 |
Total Medical Submitted Charge Amount |
39606 |
Total Medical Medicare Allowed Amount |
21210.72 |
Total Medical Medicare Payment Amount |
12913.32 |
Total Medical Medicare Standardized Payment Amount |
13367.16 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
54 |
Number Of Beneficiaries Age 75 to 84 |
12 |
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
48 |
Number Of Male Beneficiaries |
36 |
Number Of Non Hispanic White Beneficiaries |
72 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
20 |
Percent Of With Diabetes |
13 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
40 |
Percent Of With Ischemic Heart Disease |
13 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
0.7264 |