National Provider Identifier [NPI]: |
1285634402 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
MARILYN |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
FNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2004 NO. GOLIAD STREET |
Street Address 2 Of The Provider |
|
City Of The Provider |
ROCKWALL |
Zip Code Of The Provider |
75087 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
312 |
Number Of Medicare Beneficiaries |
151 |
Total Submitted Charge Amount |
13507.85 |
Total Medicare Allowed Amount |
12093.1 |
Total Medicare Payment Amount |
9938.71 |
Total Medicare Standardized Payment Amount |
11548.21 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
115 |
Number Of Medicare Beneficiaries With Drug Services |
94 |
Total Drug Submitted ChargeAmount |
4450.85 |
Total Drug Medicare AllowedAmount |
4154.45 |
Total Drug Medicare PaymentAmount |
4040.99 |
Total Drug Medicare Standardized Payment Amount |
4040.99 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
197 |
Number Of Medicare Beneficiaries With Medical Services |
150 |
Total Medical Submitted Charge Amount |
9057 |
Total Medical Medicare Allowed Amount |
7938.65 |
Total Medical Medicare Payment Amount |
5897.72 |
Total Medical Medicare Standardized Payment Amount |
7507.22 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
96 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
83 |
Number Of Male Beneficiaries |
68 |
Number Of Non Hispanic White Beneficiaries |
138 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
11 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6729 |