National Provider Identifier [NPI]: |
1518050012 |
Last Name Of The Provider |
BRANDWENE |
First Name Of The Provider |
ELLIOTT |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11500 BROOKSHIRE AVENUE |
Street Address 2 Of The Provider |
|
City Of The Provider |
DOWNEY |
Zip Code Of The Provider |
90241 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
1323 |
Number Of Medicare Beneficiaries |
1014 |
Total Submitted Charge Amount |
1102632 |
Total Medicare Allowed Amount |
198787.04 |
Total Medicare Payment Amount |
154181.89 |
Total Medicare Standardized Payment Amount |
151299.52 |
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 |
52 |
Number Of Medical Services |
1323 |
Number Of Medicare Beneficiaries With Medical Services |
1014 |
Total Medical Submitted Charge Amount |
1102632 |
Total Medical Medicare Allowed Amount |
198787.04 |
Total Medical Medicare Payment Amount |
154181.89 |
Total Medical Medicare Standardized Payment Amount |
151299.52 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
243 |
Number Of Beneficiaries Age 65 to 74 |
286 |
Number Of Beneficiaries Age 75 to 84 |
219 |
Number Of Beneficiaries Age Greater 84 |
266 |
Number Of Female Beneficiaries |
536 |
Number Of Male Beneficiaries |
478 |
Number Of Non Hispanic White Beneficiaries |
861 |
Number Of Black or African American Beneficiaries |
23 |
Number Of AsianPacific Islander Beneficiaries |
20 |
Number Of Hispanic Beneficiaries |
82 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
624 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
390 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.7717 |