National Provider Identifier [NPI]: |
1386630580 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
BARY |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1441 E SUNSHINE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658041211 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
630 |
Number Of Medicare Beneficiaries |
430 |
Total Submitted Charge Amount |
55047.61 |
Total Medicare Allowed Amount |
53145.62 |
Total Medicare Payment Amount |
34338.55 |
Total Medicare Standardized Payment Amount |
39547.19 |
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 |
15 |
Number Of Medical Services |
630 |
Number Of Medicare Beneficiaries With Medical Services |
430 |
Total Medical Submitted Charge Amount |
55047.61 |
Total Medical Medicare Allowed Amount |
53145.62 |
Total Medical Medicare Payment Amount |
34338.55 |
Total Medical Medicare Standardized Payment Amount |
39547.19 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
58 |
Number Of Beneficiaries Age 65 to 74 |
203 |
Number Of Beneficiaries Age 75 to 84 |
124 |
Number Of Beneficiaries Age Greater 84 |
45 |
Number Of Female Beneficiaries |
280 |
Number Of Male Beneficiaries |
150 |
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 |
380 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9391 |