National Provider Identifier [NPI]: |
1205240413 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
BRANDON |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
NP-C |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
744 MIDDLE CREEK RD STE 108 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SEVIERVILLE |
Zip Code Of The Provider |
378625036 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
338 |
Number Of Medicare Beneficiaries |
103 |
Total Submitted Charge Amount |
62277 |
Total Medicare Allowed Amount |
21925.85 |
Total Medicare Payment Amount |
17710.22 |
Total Medicare Standardized Payment Amount |
21667.16 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
45 |
Number Of Medicare Beneficiaries With Drug Services |
28 |
Total Drug Submitted ChargeAmount |
5022 |
Total Drug Medicare AllowedAmount |
2332.52 |
Total Drug Medicare PaymentAmount |
2273.12 |
Total Drug Medicare Standardized Payment Amount |
2273.12 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
293 |
Number Of Medicare Beneficiaries With Medical Services |
103 |
Total Medical Submitted Charge Amount |
57255 |
Total Medical Medicare Allowed Amount |
19593.33 |
Total Medical Medicare Payment Amount |
15437.1 |
Total Medical Medicare Standardized Payment Amount |
19394.04 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
50 |
Number Of Beneficiaries Age 75 to 84 |
28 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
48 |
Number Of Male Beneficiaries |
55 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
77 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
26 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
16 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
67 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
40 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6208 |