National Provider Identifier [NPI]: |
1265477293 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1725 W HARRISON ST |
Street Address 2 Of The Provider |
SUITE 207 |
City Of The Provider |
CHICAGO |
Zip Code Of The Provider |
606123841 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gastroenterology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
46 |
Number Of Services |
818 |
Number Of Medicare Beneficiaries |
485 |
Total Submitted Charge Amount |
618493 |
Total Medicare Allowed Amount |
121487.2 |
Total Medicare Payment Amount |
93869.26 |
Total Medicare Standardized Payment Amount |
86779.11 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
|
Number Of Drug Services |
|
Number Of Medicare Beneficiaries With Drug Services |
|
Total Drug Submitted ChargeAmount |
|
Total Drug Medicare AllowedAmount |
|
Total Drug Medicare PaymentAmount |
|
Total Drug Medicare Standardized Payment Amount |
|
Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
|
Number Of Medical Services |
|
Number Of Medicare Beneficiaries With Medical Services |
|
Total Medical Submitted Charge Amount |
|
Total Medical Medicare Allowed Amount |
|
Total Medical Medicare Payment Amount |
|
Total Medical Medicare Standardized Payment Amount |
|
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
227 |
Number Of Beneficiaries Age 75 to 84 |
122 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
291 |
Number Of Male Beneficiaries |
194 |
Number Of Non Hispanic White Beneficiaries |
247 |
Number Of Black or African American Beneficiaries |
172 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
52 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
356 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
129 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.699 |