National Provider Identifier [NPI]: |
1154558534 |
Last Name Of The Provider |
BUTLER |
First Name Of The Provider |
BROOKE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2411 FOUNTAIN VIEW DR |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
HOUSTON |
Zip Code Of The Provider |
770574817 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
171 |
Number Of Medicare Beneficiaries |
165 |
Total Submitted Charge Amount |
134135.4 |
Total Medicare Allowed Amount |
24675.68 |
Total Medicare Payment Amount |
18808.48 |
Total Medicare Standardized Payment Amount |
18796.83 |
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 |
46 |
Number Of Medical Services |
171 |
Number Of Medicare Beneficiaries With Medical Services |
165 |
Total Medical Submitted Charge Amount |
134135.4 |
Total Medical Medicare Allowed Amount |
24675.68 |
Total Medical Medicare Payment Amount |
18808.48 |
Total Medical Medicare Standardized Payment Amount |
18796.83 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
49 |
Number Of Beneficiaries Age 65 to 74 |
47 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
20 |
Number Of Female Beneficiaries |
81 |
Number Of Male Beneficiaries |
84 |
Number Of Non Hispanic White Beneficiaries |
67 |
Number Of Black or African American Beneficiaries |
52 |
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 |
94 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
19 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
68 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
3.7874 |