National Provider Identifier [NPI]: |
1891053666 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
JENNIFER |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
P.A.-C. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1923 S UTICA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
TULSA |
Zip Code Of The Provider |
741046520 |
State Code Of The Provider |
OK |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
183 |
Number Of Medicare Beneficiaries |
142 |
Total Submitted Charge Amount |
55832 |
Total Medicare Allowed Amount |
9219.36 |
Total Medicare Payment Amount |
7059.37 |
Total Medicare Standardized Payment Amount |
8667.93 |
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 |
24 |
Number Of Medical Services |
183 |
Number Of Medicare Beneficiaries With Medical Services |
142 |
Total Medical Submitted Charge Amount |
55832 |
Total Medical Medicare Allowed Amount |
9219.36 |
Total Medical Medicare Payment Amount |
7059.37 |
Total Medical Medicare Standardized Payment Amount |
8667.93 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
33 |
Number Of Beneficiaries Age 75 to 84 |
47 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
92 |
Number Of Male Beneficiaries |
50 |
Number Of Non Hispanic White Beneficiaries |
122 |
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 |
95 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
47 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
46 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
31 |
Percent Of With Depression |
52 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.5935 |