National Provider Identifier [NPI]: |
1386811289 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
CARLY |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
20 YORK ST CB-2041 |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW HAVEN |
Zip Code Of The Provider |
065103220 |
State Code Of The Provider |
CT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1029 |
Number Of Medicare Beneficiaries |
366 |
Total Submitted Charge Amount |
250900 |
Total Medicare Allowed Amount |
94605 |
Total Medicare Payment Amount |
73659.15 |
Total Medicare Standardized Payment Amount |
69574.92 |
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 |
17 |
Number Of Medical Services |
1029 |
Number Of Medicare Beneficiaries With Medical Services |
366 |
Total Medical Submitted Charge Amount |
250900 |
Total Medical Medicare Allowed Amount |
94605 |
Total Medical Medicare Payment Amount |
73659.15 |
Total Medical Medicare Standardized Payment Amount |
69574.92 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
97 |
Number Of Beneficiaries Age 65 to 74 |
87 |
Number Of Beneficiaries Age 75 to 84 |
97 |
Number Of Beneficiaries Age Greater 84 |
85 |
Number Of Female Beneficiaries |
196 |
Number Of Male Beneficiaries |
170 |
Number Of Non Hispanic White Beneficiaries |
263 |
Number Of Black or African American Beneficiaries |
67 |
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 |
166 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
200 |
Percent Of With Atrial Fibrillation |
29 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
54 |
Percent Of With Chronic Kidney Disease |
62 |
Percent Of With Chronic Obstructive Pulmonary Disease |
39 |
Percent Of With Depression |
49 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
3.0342 |