National Provider Identifier [NPI]: |
1922040971 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
MARVIN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 CONCORD PLAZA DR |
Street Address 2 Of The Provider |
300 |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782166905 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Orthopedic Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
165 |
Number Of Services |
10430 |
Number Of Medicare Beneficiaries |
1102 |
Total Submitted Charge Amount |
2359843.44 |
Total Medicare Allowed Amount |
562120.23 |
Total Medicare Payment Amount |
421726.45 |
Total Medicare Standardized Payment Amount |
442730.87 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
4291 |
Number Of Medicare Beneficiaries With Drug Services |
293 |
Total Drug Submitted ChargeAmount |
229159.77 |
Total Drug Medicare AllowedAmount |
103741.33 |
Total Drug Medicare PaymentAmount |
81057.43 |
Total Drug Medicare Standardized Payment Amount |
81057.43 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
155 |
Number Of Medical Services |
6139 |
Number Of Medicare Beneficiaries With Medical Services |
1102 |
Total Medical Submitted Charge Amount |
2130683.67 |
Total Medical Medicare Allowed Amount |
458378.9 |
Total Medical Medicare Payment Amount |
340669.02 |
Total Medical Medicare Standardized Payment Amount |
361673.44 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
146 |
Number Of Beneficiaries Age 65 to 74 |
574 |
Number Of Beneficiaries Age 75 to 84 |
284 |
Number Of Beneficiaries Age Greater 84 |
98 |
Number Of Female Beneficiaries |
747 |
Number Of Male Beneficiaries |
355 |
Number Of Non Hispanic White Beneficiaries |
768 |
Number Of Black or African American Beneficiaries |
44 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
271 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
977 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
68 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.1984 |