National Provider Identifier [NPI]: |
1063487254 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
D.C. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2410 SAINT ANDREWS BLVD |
Street Address 2 Of The Provider |
SUITE A |
City Of The Provider |
PANAMA CITY |
Zip Code Of The Provider |
324052169 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Chiropractic |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
1 |
Number Of Services |
521 |
Number Of Medicare Beneficiaries |
128 |
Total Submitted Charge Amount |
28655 |
Total Medicare Allowed Amount |
13746.41 |
Total Medicare Payment Amount |
9028.02 |
Total Medicare Standardized Payment Amount |
9843.24 |
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 |
1 |
Number Of Medical Services |
521 |
Number Of Medicare Beneficiaries With Medical Services |
128 |
Total Medical Submitted Charge Amount |
28655 |
Total Medical Medicare Allowed Amount |
13746.41 |
Total Medical Medicare Payment Amount |
9028.02 |
Total Medical Medicare Standardized Payment Amount |
9843.24 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
40 |
Number Of Beneficiaries Age Greater 84 |
11 |
Number Of Female Beneficiaries |
64 |
Number Of Male Beneficiaries |
64 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
111 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
17 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9217 |