National Provider Identifier [NPI]: |
1043249568 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
MARTY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1350 S HICKORY STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
MELBOURNE |
Zip Code Of The Provider |
32901 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
507 |
Number Of Medicare Beneficiaries |
356 |
Total Submitted Charge Amount |
276253 |
Total Medicare Allowed Amount |
60791.34 |
Total Medicare Payment Amount |
46524.5 |
Total Medicare Standardized Payment Amount |
45708.2 |
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 |
17 |
Number Of Medical Services |
507 |
Number Of Medicare Beneficiaries With Medical Services |
356 |
Total Medical Submitted Charge Amount |
276253 |
Total Medical Medicare Allowed Amount |
60791.34 |
Total Medical Medicare Payment Amount |
46524.5 |
Total Medical Medicare Standardized Payment Amount |
45708.2 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
101 |
Number Of Beneficiaries Age 75 to 84 |
119 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
188 |
Number Of Male Beneficiaries |
168 |
Number Of Non Hispanic White Beneficiaries |
282 |
Number Of Black or African American Beneficiaries |
36 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
263 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
93 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
29 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
58 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
17 |
Average HCC Risk Score Of Beneficiaries |
2.1848 |