National Provider Identifier [NPI]: |
1659319804 |
Last Name Of The Provider |
EDWARDS-BROWN |
First Name Of The Provider |
MARY |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1701 N SENATE BLVD |
Street Address 2 Of The Provider |
ROOM 1204A |
City Of The Provider |
INDIANAPOLIS |
Zip Code Of The Provider |
462021239 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
682 |
Number Of Medicare Beneficiaries |
577 |
Total Submitted Charge Amount |
122367 |
Total Medicare Allowed Amount |
39605.57 |
Total Medicare Payment Amount |
29476.51 |
Total Medicare Standardized Payment Amount |
31293.3 |
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 |
37 |
Number Of Medical Services |
682 |
Number Of Medicare Beneficiaries With Medical Services |
577 |
Total Medical Submitted Charge Amount |
122367 |
Total Medical Medicare Allowed Amount |
39605.57 |
Total Medical Medicare Payment Amount |
29476.51 |
Total Medical Medicare Standardized Payment Amount |
31293.3 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
147 |
Number Of Beneficiaries Age 65 to 74 |
182 |
Number Of Beneficiaries Age 75 to 84 |
150 |
Number Of Beneficiaries Age Greater 84 |
98 |
Number Of Female Beneficiaries |
315 |
Number Of Male Beneficiaries |
262 |
Number Of Non Hispanic White Beneficiaries |
476 |
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 |
378 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
199 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
49 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
29 |
Average HCC Risk Score Of Beneficiaries |
1.912 |