National Provider Identifier [NPI]: |
1689787459 |
Last Name Of The Provider |
BRICK |
First Name Of The Provider |
PHILLIP |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
605 OLD BALLAS RD |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631417000 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
129 |
Number Of Services |
3502 |
Number Of Medicare Beneficiaries |
312 |
Total Submitted Charge Amount |
316590.17 |
Total Medicare Allowed Amount |
132728.65 |
Total Medicare Payment Amount |
101142.13 |
Total Medicare Standardized Payment Amount |
102878.56 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
82 |
Number Of Medicare Beneficiaries With Drug Services |
68 |
Total Drug Submitted ChargeAmount |
3627 |
Total Drug Medicare AllowedAmount |
1862.05 |
Total Drug Medicare PaymentAmount |
1823.16 |
Total Drug Medicare Standardized Payment Amount |
1823.16 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
120 |
Number Of Medical Services |
3420 |
Number Of Medicare Beneficiaries With Medical Services |
312 |
Total Medical Submitted Charge Amount |
312963.17 |
Total Medical Medicare Allowed Amount |
130866.6 |
Total Medical Medicare Payment Amount |
99318.97 |
Total Medical Medicare Standardized Payment Amount |
101055.4 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
148 |
Number Of Beneficiaries Age 75 to 84 |
69 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
153 |
Number Of Male Beneficiaries |
159 |
Number Of Non Hispanic White Beneficiaries |
257 |
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 |
278 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
34 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
26 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1664 |