National Provider Identifier [NPI]: |
1215092630 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
DENNIS |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1235 E CHEROKEE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658042203 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
910 |
Number Of Medicare Beneficiaries |
407 |
Total Submitted Charge Amount |
159158 |
Total Medicare Allowed Amount |
82940.4 |
Total Medicare Payment Amount |
62861.94 |
Total Medicare Standardized Payment Amount |
66112.04 |
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 |
18 |
Number Of Medical Services |
910 |
Number Of Medicare Beneficiaries With Medical Services |
407 |
Total Medical Submitted Charge Amount |
159158 |
Total Medical Medicare Allowed Amount |
82940.4 |
Total Medical Medicare Payment Amount |
62861.94 |
Total Medical Medicare Standardized Payment Amount |
66112.04 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
95 |
Number Of Beneficiaries Age 65 to 74 |
129 |
Number Of Beneficiaries Age 75 to 84 |
111 |
Number Of Beneficiaries Age Greater 84 |
72 |
Number Of Female Beneficiaries |
213 |
Number Of Male Beneficiaries |
194 |
Number Of Non Hispanic White Beneficiaries |
396 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
257 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
150 |
Percent Of With Atrial Fibrillation |
30 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
48 |
Percent Of With Chronic Kidney Disease |
53 |
Percent Of With Chronic Obstructive Pulmonary Disease |
41 |
Percent Of With Depression |
46 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
14 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.1122 |