National Provider Identifier [NPI]: |
1972770378 |
Last Name Of The Provider |
BRUYNINCKX |
First Name Of The Provider |
KYLE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
261 HIGHWAY 132 |
Street Address 2 Of The Provider |
|
City Of The Provider |
MANGHAM |
Zip Code Of The Provider |
712595269 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pediatric Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
150 |
Number Of Services |
18689 |
Number Of Medicare Beneficiaries |
790 |
Total Submitted Charge Amount |
801097.14 |
Total Medicare Allowed Amount |
379823.36 |
Total Medicare Payment Amount |
296332.53 |
Total Medicare Standardized Payment Amount |
301332.5 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
25 |
Number Of Drug Services |
8338 |
Number Of Medicare Beneficiaries With Drug Services |
580 |
Total Drug Submitted ChargeAmount |
52599.6 |
Total Drug Medicare AllowedAmount |
17091.94 |
Total Drug Medicare PaymentAmount |
14673.85 |
Total Drug Medicare Standardized Payment Amount |
14673.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
125 |
Number Of Medical Services |
10351 |
Number Of Medicare Beneficiaries With Medical Services |
790 |
Total Medical Submitted Charge Amount |
748497.54 |
Total Medical Medicare Allowed Amount |
362731.42 |
Total Medical Medicare Payment Amount |
281658.68 |
Total Medical Medicare Standardized Payment Amount |
286658.65 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
161 |
Number Of Beneficiaries Age 65 to 74 |
332 |
Number Of Beneficiaries Age 75 to 84 |
216 |
Number Of Beneficiaries Age Greater 84 |
81 |
Number Of Female Beneficiaries |
453 |
Number Of Male Beneficiaries |
337 |
Number Of Non Hispanic White Beneficiaries |
560 |
Number Of Black or African American Beneficiaries |
|
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 |
463 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
327 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
2 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2346 |