National Provider Identifier [NPI]: |
1366580136 |
Last Name Of The Provider |
BROWNING |
First Name Of The Provider |
JIMMIE |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1555 NORTHWAY DRIVE |
Street Address 2 Of The Provider |
SUITE 200 |
City Of The Provider |
ST CLOUD |
Zip Code Of The Provider |
563034913 |
State Code Of The Provider |
MN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
677 |
Number Of Medicare Beneficiaries |
220 |
Total Submitted Charge Amount |
109747 |
Total Medicare Allowed Amount |
45619.42 |
Total Medicare Payment Amount |
33953.03 |
Total Medicare Standardized Payment Amount |
34657.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
75 |
Number Of Medicare Beneficiaries With Drug Services |
19 |
Total Drug Submitted ChargeAmount |
747.75 |
Total Drug Medicare AllowedAmount |
403.53 |
Total Drug Medicare PaymentAmount |
350.15 |
Total Drug Medicare Standardized Payment Amount |
350.15 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
51 |
Number Of Medical Services |
602 |
Number Of Medicare Beneficiaries With Medical Services |
220 |
Total Medical Submitted Charge Amount |
108999.25 |
Total Medical Medicare Allowed Amount |
45215.89 |
Total Medical Medicare Payment Amount |
33602.88 |
Total Medical Medicare Standardized Payment Amount |
34307.21 |
Average Age Of Beneficiaries |
58 |
Number Of Beneficiaries Age Less65 |
151 |
Number Of Beneficiaries Age 65 to 74 |
32 |
Number Of Beneficiaries Age 75 to 84 |
16 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
121 |
Number Of Non Hispanic White Beneficiaries |
175 |
Number Of Black or African American Beneficiaries |
31 |
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 |
70 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
150 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
48 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
17 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.6348 |