National Provider Identifier [NPI]: |
1326083643 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
KENDALL |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1380 RIVER BEND DRIVE |
Street Address 2 Of The Provider |
METROCARE, BUSINESS OPERATIONS |
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
75247 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
546 |
Number Of Medicare Beneficiaries |
56 |
Total Submitted Charge Amount |
12841.43 |
Total Medicare Allowed Amount |
12242.51 |
Total Medicare Payment Amount |
9147.29 |
Total Medicare Standardized Payment Amount |
9564.19 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
50 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
|
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
0 |
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
41 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
0 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
0 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
0 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
23 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
30 |
Percent Of With Ischemic Heart Disease |
|
Percent Of With Osteoporosis |
34 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
32 |
Percent Of With Stroke |
0 |
Average HCC Risk Score Of Beneficiaries |
1.2094 |