National Provider Identifier [NPI]: |
1114923166 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
KEITH |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3333 SPRINGHILL DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
NORTH LITTLE ROCK |
Zip Code Of The Provider |
721172922 |
State Code Of The Provider |
AR |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
1352 |
Number Of Medicare Beneficiaries |
864 |
Total Submitted Charge Amount |
427582 |
Total Medicare Allowed Amount |
135984.16 |
Total Medicare Payment Amount |
103015.73 |
Total Medicare Standardized Payment Amount |
109290.2 |
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 |
39 |
Number Of Medical Services |
1352 |
Number Of Medicare Beneficiaries With Medical Services |
864 |
Total Medical Submitted Charge Amount |
427582 |
Total Medical Medicare Allowed Amount |
135984.16 |
Total Medical Medicare Payment Amount |
103015.73 |
Total Medical Medicare Standardized Payment Amount |
109290.2 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
224 |
Number Of Beneficiaries Age 65 to 74 |
256 |
Number Of Beneficiaries Age 75 to 84 |
234 |
Number Of Beneficiaries Age Greater 84 |
150 |
Number Of Female Beneficiaries |
528 |
Number Of Male Beneficiaries |
336 |
Number Of Non Hispanic White Beneficiaries |
677 |
Number Of Black or African American Beneficiaries |
171 |
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 |
559 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
305 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.9875 |