National Provider Identifier [NPI]: |
1891854303 |
Last Name Of The Provider |
BREWER |
First Name Of The Provider |
DEBORAH |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
NP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2464 ROSWELL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MARIETTA |
Zip Code Of The Provider |
300624954 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
256 |
Number Of Medicare Beneficiaries |
51 |
Total Submitted Charge Amount |
6850.55 |
Total Medicare Allowed Amount |
5653.2 |
Total Medicare Payment Amount |
4000.03 |
Total Medicare Standardized Payment Amount |
4500.8 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
195 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
3239.45 |
Total Drug Medicare AllowedAmount |
3030.71 |
Total Drug Medicare PaymentAmount |
2465.18 |
Total Drug Medicare Standardized Payment Amount |
2465.18 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
12 |
Number Of Medical Services |
61 |
Number Of Medicare Beneficiaries With Medical Services |
51 |
Total Medical Submitted Charge Amount |
3611.1 |
Total Medical Medicare Allowed Amount |
2622.49 |
Total Medical Medicare Payment Amount |
1534.85 |
Total Medical Medicare Standardized Payment Amount |
2035.62 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
31 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
37 |
Number Of Male Beneficiaries |
14 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
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 |
|
Percent Of With Chronic Kidney Disease |
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Percent Of With Chronic Obstructive Pulmonary Disease |
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Percent Of With Depression |
|
Percent Of With Diabetes |
|
Percent Of With Hyperlipidemia |
49 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
22 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
|
Percent Of With Schizophrenia Other PsychoticDisorders |
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Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6951 |