National Provider Identifier [NPI]: |
1447242060 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
RONALD |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1160 E 3900 S |
Street Address 2 Of The Provider |
STE 2000 |
City Of The Provider |
SALT LAKE CITY |
Zip Code Of The Provider |
841241202 |
State Code Of The Provider |
UT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
48 |
Number Of Services |
1805 |
Number Of Medicare Beneficiaries |
776 |
Total Submitted Charge Amount |
365634 |
Total Medicare Allowed Amount |
151070.74 |
Total Medicare Payment Amount |
107750.24 |
Total Medicare Standardized Payment Amount |
112581.04 |
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 |
78 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
250 |
Number Of Beneficiaries Age 75 to 84 |
311 |
Number Of Beneficiaries Age Greater 84 |
182 |
Number Of Female Beneficiaries |
375 |
Number Of Male Beneficiaries |
401 |
Number Of Non Hispanic White Beneficiaries |
743 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
739 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
37 |
Percent Of With Atrial Fibrillation |
46 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
36 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.3393 |