National Provider Identifier [NPI]: |
1811962251 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
VICKIE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
PA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3330 NW 56TH ST |
Street Address 2 Of The Provider |
SUITE 206 |
City Of The Provider |
OKLAHOMA CITY |
Zip Code Of The Provider |
731124479 |
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 |
25 |
Number Of Services |
1286 |
Number Of Medicare Beneficiaries |
563 |
Total Submitted Charge Amount |
114225.14 |
Total Medicare Allowed Amount |
95402.24 |
Total Medicare Payment Amount |
74192.07 |
Total Medicare Standardized Payment Amount |
92319.69 |
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 |
25 |
Number Of Medical Services |
1286 |
Number Of Medicare Beneficiaries With Medical Services |
563 |
Total Medical Submitted Charge Amount |
114225.14 |
Total Medical Medicare Allowed Amount |
95402.24 |
Total Medical Medicare Payment Amount |
74192.07 |
Total Medical Medicare Standardized Payment Amount |
92319.69 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
180 |
Number Of Beneficiaries Age 65 to 74 |
191 |
Number Of Beneficiaries Age 75 to 84 |
135 |
Number Of Beneficiaries Age Greater 84 |
57 |
Number Of Female Beneficiaries |
279 |
Number Of Male Beneficiaries |
284 |
Number Of Non Hispanic White Beneficiaries |
422 |
Number Of Black or African American Beneficiaries |
66 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
50 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
366 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
197 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
61 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
40 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
58 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
64 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
4.1387 |