National Provider Identifier [NPI]: |
1083813240 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
DIXIE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
CNP |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5903 RIDGEWOOD RD |
Street Address 2 Of The Provider |
SUITE 340 |
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392113700 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
4 |
Number Of Services |
220 |
Number Of Medicare Beneficiaries |
131 |
Total Submitted Charge Amount |
129300 |
Total Medicare Allowed Amount |
30916.16 |
Total Medicare Payment Amount |
23273.33 |
Total Medicare Standardized Payment Amount |
29342.1 |
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 |
4 |
Number Of Medical Services |
220 |
Number Of Medicare Beneficiaries With Medical Services |
131 |
Total Medical Submitted Charge Amount |
129300 |
Total Medical Medicare Allowed Amount |
30916.16 |
Total Medical Medicare Payment Amount |
23273.33 |
Total Medical Medicare Standardized Payment Amount |
29342.1 |
Average Age Of Beneficiaries |
61 |
Number Of Beneficiaries Age Less65 |
75 |
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 |
63 |
Number Of Male Beneficiaries |
68 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
90 |
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 |
52 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
58 |
Percent Of With Chronic Kidney Disease |
75 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
63 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
27 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
7.9572 |