National Provider Identifier [NPI]: |
1326078841 |
Last Name Of The Provider |
BRITT |
First Name Of The Provider |
WALTER |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1801 CLIFTY DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
MADISON |
Zip Code Of The Provider |
472501627 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
2567 |
Number Of Medicare Beneficiaries |
265 |
Total Submitted Charge Amount |
181615 |
Total Medicare Allowed Amount |
92741.44 |
Total Medicare Payment Amount |
58983.35 |
Total Medicare Standardized Payment Amount |
64824.7 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
546 |
Number Of Medicare Beneficiaries With Drug Services |
143 |
Total Drug Submitted ChargeAmount |
16852 |
Total Drug Medicare AllowedAmount |
3931.42 |
Total Drug Medicare PaymentAmount |
3598.54 |
Total Drug Medicare Standardized Payment Amount |
3598.54 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
2021 |
Number Of Medicare Beneficiaries With Medical Services |
265 |
Total Medical Submitted Charge Amount |
164763 |
Total Medical Medicare Allowed Amount |
88810.02 |
Total Medical Medicare Payment Amount |
55384.81 |
Total Medical Medicare Standardized Payment Amount |
61226.16 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
166 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
24 |
Number Of Female Beneficiaries |
137 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
246 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
19 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
33 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.737 |