National Provider Identifier [NPI]: |
1134389711 |
Last Name Of The Provider |
EARNEST |
First Name Of The Provider |
BRETT |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
910 GRUENE RD # 2 |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW BRAUNFELS |
Zip Code Of The Provider |
781303919 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
340 |
Number Of Medicare Beneficiaries |
63 |
Total Submitted Charge Amount |
23326.54 |
Total Medicare Allowed Amount |
15506.13 |
Total Medicare Payment Amount |
11449.25 |
Total Medicare Standardized Payment Amount |
12427.26 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
35 |
Number Of Medicare Beneficiaries With Drug Services |
25 |
Total Drug Submitted ChargeAmount |
1114.99 |
Total Drug Medicare AllowedAmount |
531.66 |
Total Drug Medicare PaymentAmount |
507.94 |
Total Drug Medicare Standardized Payment Amount |
507.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
33 |
Number Of Medical Services |
305 |
Number Of Medicare Beneficiaries With Medical Services |
63 |
Total Medical Submitted Charge Amount |
22211.55 |
Total Medical Medicare Allowed Amount |
14974.47 |
Total Medical Medicare Payment Amount |
10941.31 |
Total Medical Medicare Standardized Payment Amount |
11919.32 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
39 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
36 |
Number Of Male Beneficiaries |
27 |
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 |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
24 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
24 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1773 |