National Provider Identifier [NPI]: |
1538445200 |
Last Name Of The Provider |
SANDERS |
First Name Of The Provider |
BRETT |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
7727 LAKE UNDERHILL RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
ORLANDO |
Zip Code Of The Provider |
328228224 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
481 |
Number Of Medicare Beneficiaries |
284 |
Total Submitted Charge Amount |
320726 |
Total Medicare Allowed Amount |
55380.81 |
Total Medicare Payment Amount |
43092.24 |
Total Medicare Standardized Payment Amount |
42717.7 |
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 |
20 |
Number Of Medical Services |
481 |
Number Of Medicare Beneficiaries With Medical Services |
284 |
Total Medical Submitted Charge Amount |
320726 |
Total Medical Medicare Allowed Amount |
55380.81 |
Total Medical Medicare Payment Amount |
43092.24 |
Total Medical Medicare Standardized Payment Amount |
42717.7 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
79 |
Number Of Beneficiaries Age 75 to 84 |
59 |
Number Of Beneficiaries Age Greater 84 |
71 |
Number Of Female Beneficiaries |
163 |
Number Of Male Beneficiaries |
121 |
Number Of Non Hispanic White Beneficiaries |
194 |
Number Of Black or African American Beneficiaries |
47 |
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 |
183 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
101 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
30 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
46 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
50 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
60 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
18 |
Average HCC Risk Score Of Beneficiaries |
2.2167 |