National Provider Identifier [NPI]: |
1992834261 |
Last Name Of The Provider |
BRUNNER |
First Name Of The Provider |
HILLARY |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
D.P.M. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2626 JOHN BEN SHEPPERD PKWY |
Street Address 2 Of The Provider |
A-100 |
City Of The Provider |
ODESSA |
Zip Code Of The Provider |
797611958 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
66 |
Number Of Services |
4122 |
Number Of Medicare Beneficiaries |
738 |
Total Submitted Charge Amount |
726982.88 |
Total Medicare Allowed Amount |
224714.21 |
Total Medicare Payment Amount |
159067.61 |
Total Medicare Standardized Payment Amount |
181468.11 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
167 |
Number Of Medicare Beneficiaries With Drug Services |
58 |
Total Drug Submitted ChargeAmount |
3435 |
Total Drug Medicare AllowedAmount |
141.85 |
Total Drug Medicare PaymentAmount |
97.66 |
Total Drug Medicare Standardized Payment Amount |
97.66 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
64 |
Number Of Medical Services |
3955 |
Number Of Medicare Beneficiaries With Medical Services |
738 |
Total Medical Submitted Charge Amount |
723547.88 |
Total Medical Medicare Allowed Amount |
224572.36 |
Total Medical Medicare Payment Amount |
158969.95 |
Total Medical Medicare Standardized Payment Amount |
181370.45 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
211 |
Number Of Beneficiaries Age 75 to 84 |
250 |
Number Of Beneficiaries Age Greater 84 |
189 |
Number Of Female Beneficiaries |
471 |
Number Of Male Beneficiaries |
267 |
Number Of Non Hispanic White Beneficiaries |
546 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
157 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
433 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
305 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
41 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
58 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.751 |