National Provider Identifier [NPI]: |
1033116736 |
Last Name Of The Provider |
HARRISON |
First Name Of The Provider |
BRADY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
PA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2455 NE LOOP 410 |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782175649 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
36 |
Number Of Services |
289 |
Number Of Medicare Beneficiaries |
97 |
Total Submitted Charge Amount |
19554 |
Total Medicare Allowed Amount |
11138.69 |
Total Medicare Payment Amount |
7371.39 |
Total Medicare Standardized Payment Amount |
9491.87 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
28 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
101 |
Total Drug Medicare AllowedAmount |
74.49 |
Total Drug Medicare PaymentAmount |
49.38 |
Total Drug Medicare Standardized Payment Amount |
49.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
261 |
Number Of Medicare Beneficiaries With Medical Services |
97 |
Total Medical Submitted Charge Amount |
19453 |
Total Medical Medicare Allowed Amount |
11064.2 |
Total Medical Medicare Payment Amount |
7322.01 |
Total Medical Medicare Standardized Payment Amount |
9442.49 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
41 |
Number Of Beneficiaries Age 75 to 84 |
27 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
60 |
Number Of Male Beneficiaries |
37 |
Number Of Non Hispanic White Beneficiaries |
74 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
24 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1298 |