National Provider Identifier [NPI]: |
1598731473 |
Last Name Of The Provider |
BROOKS |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
V |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1231 PINE GROVE AVE |
Street Address 2 Of The Provider |
INFECTIOUS DISEASE, SUITE 1B |
City Of The Provider |
PORT HURON |
Zip Code Of The Provider |
480603500 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Infectious Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
2016 |
Number Of Medicare Beneficiaries |
558 |
Total Submitted Charge Amount |
322397 |
Total Medicare Allowed Amount |
208896.1 |
Total Medicare Payment Amount |
159035.67 |
Total Medicare Standardized Payment Amount |
163879.89 |
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 |
25 |
Number Of Medical Services |
2016 |
Number Of Medicare Beneficiaries With Medical Services |
558 |
Total Medical Submitted Charge Amount |
322397 |
Total Medical Medicare Allowed Amount |
208896.1 |
Total Medical Medicare Payment Amount |
159035.67 |
Total Medical Medicare Standardized Payment Amount |
163879.89 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
167 |
Number Of Beneficiaries Age 65 to 74 |
165 |
Number Of Beneficiaries Age 75 to 84 |
141 |
Number Of Beneficiaries Age Greater 84 |
85 |
Number Of Female Beneficiaries |
273 |
Number Of Male Beneficiaries |
285 |
Number Of Non Hispanic White Beneficiaries |
528 |
Number Of Black or African American Beneficiaries |
18 |
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 |
367 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
191 |
Percent Of With Atrial Fibrillation |
25 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
19 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
56 |
Percent Of With Chronic Obstructive Pulmonary Disease |
44 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
55 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
72 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
64 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.6874 |