National Provider Identifier [NPI]: |
1447226451 |
Last Name Of The Provider |
BREWER |
First Name Of The Provider |
JONATHAN |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1501 NE MEDICAL CENTER DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BEND |
Zip Code Of The Provider |
977016051 |
State Code Of The Provider |
OR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
74 |
Number Of Services |
3234 |
Number Of Medicare Beneficiaries |
717 |
Total Submitted Charge Amount |
1093231.23 |
Total Medicare Allowed Amount |
314712.91 |
Total Medicare Payment Amount |
239990.72 |
Total Medicare Standardized Payment Amount |
248750.45 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
605 |
Number Of Medicare Beneficiaries With Drug Services |
218 |
Total Drug Submitted ChargeAmount |
7462.49 |
Total Drug Medicare AllowedAmount |
3006.34 |
Total Drug Medicare PaymentAmount |
2940.97 |
Total Drug Medicare Standardized Payment Amount |
2940.97 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
69 |
Number Of Medical Services |
2629 |
Number Of Medicare Beneficiaries With Medical Services |
717 |
Total Medical Submitted Charge Amount |
1085768.74 |
Total Medical Medicare Allowed Amount |
311706.57 |
Total Medical Medicare Payment Amount |
237049.75 |
Total Medical Medicare Standardized Payment Amount |
245809.48 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
362 |
Number Of Beneficiaries Age 75 to 84 |
201 |
Number Of Beneficiaries Age Greater 84 |
66 |
Number Of Female Beneficiaries |
349 |
Number Of Male Beneficiaries |
368 |
Number Of Non Hispanic White Beneficiaries |
685 |
Number Of Black or African American Beneficiaries |
0 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
619 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
98 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
29 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.4453 |