National Provider Identifier [NPI]: |
1619979614 |
Last Name Of The Provider |
ATKINSON |
First Name Of The Provider |
BRANDON |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
D.O. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
12465 TIMBERLAND BLVD STE 401 |
Street Address 2 Of The Provider |
|
City Of The Provider |
FORT WORTH |
Zip Code Of The Provider |
762445215 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
745 |
Number Of Medicare Beneficiaries |
98 |
Total Submitted Charge Amount |
68029 |
Total Medicare Allowed Amount |
34441.6 |
Total Medicare Payment Amount |
22583.09 |
Total Medicare Standardized Payment Amount |
23128.17 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
46 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
1393 |
Total Drug Medicare AllowedAmount |
488.46 |
Total Drug Medicare PaymentAmount |
474.35 |
Total Drug Medicare Standardized Payment Amount |
474.35 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
699 |
Number Of Medicare Beneficiaries With Medical Services |
98 |
Total Medical Submitted Charge Amount |
66636 |
Total Medical Medicare Allowed Amount |
33953.14 |
Total Medical Medicare Payment Amount |
22108.74 |
Total Medical Medicare Standardized Payment Amount |
22653.82 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
66 |
Number Of Beneficiaries Age 75 to 84 |
14 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
43 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
80 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
86 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
12 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
23 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
26 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.7999 |