National Provider Identifier [NPI]: |
1609857721 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1001 SAM PERRY BLVD |
Street Address 2 Of The Provider |
C/O JACKIE GOMEZ |
City Of The Provider |
FREDERICKSBURG |
Zip Code Of The Provider |
224014453 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
84 |
Number Of Services |
500 |
Number Of Medicare Beneficiaries |
437 |
Total Submitted Charge Amount |
582188 |
Total Medicare Allowed Amount |
52799.21 |
Total Medicare Payment Amount |
41163.33 |
Total Medicare Standardized Payment Amount |
42184.89 |
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 |
84 |
Number Of Medical Services |
500 |
Number Of Medicare Beneficiaries With Medical Services |
437 |
Total Medical Submitted Charge Amount |
582188 |
Total Medical Medicare Allowed Amount |
52799.21 |
Total Medical Medicare Payment Amount |
41163.33 |
Total Medical Medicare Standardized Payment Amount |
42184.89 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
208 |
Number Of Beneficiaries Age 75 to 84 |
142 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
241 |
Number Of Male Beneficiaries |
196 |
Number Of Non Hispanic White Beneficiaries |
362 |
Number Of Black or African American Beneficiaries |
56 |
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 |
379 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
23 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
71 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.5836 |