National Provider Identifier [NPI]: |
1518286970 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
JUSTIN |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12210 PLUM ORCHARD DR |
Street Address 2 Of The Provider |
SUITE 212 |
City Of The Provider |
SILVER SPRING |
Zip Code Of The Provider |
209047800 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
1573 |
Number Of Medicare Beneficiaries |
273 |
Total Submitted Charge Amount |
126984.2 |
Total Medicare Allowed Amount |
94575.63 |
Total Medicare Payment Amount |
64724.8 |
Total Medicare Standardized Payment Amount |
61625.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
455 |
Number Of Medicare Beneficiaries With Drug Services |
112 |
Total Drug Submitted ChargeAmount |
19567.2 |
Total Drug Medicare AllowedAmount |
9612.85 |
Total Drug Medicare PaymentAmount |
8563.72 |
Total Drug Medicare Standardized Payment Amount |
8563.72 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
1118 |
Number Of Medicare Beneficiaries With Medical Services |
273 |
Total Medical Submitted Charge Amount |
107417 |
Total Medical Medicare Allowed Amount |
84962.78 |
Total Medical Medicare Payment Amount |
56161.08 |
Total Medical Medicare Standardized Payment Amount |
53061.51 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
163 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
17 |
Number Of Female Beneficiaries |
122 |
Number Of Male Beneficiaries |
151 |
Number Of Non Hispanic White Beneficiaries |
167 |
Number Of Black or African American Beneficiaries |
72 |
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 |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
6 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
72 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8077 |