National Provider Identifier [NPI]: |
1558384826 |
Last Name Of The Provider |
BROWN |
First Name Of The Provider |
KIMBERLEY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
PA C |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5500 PINE LAKE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LINCOLN |
Zip Code Of The Provider |
685163389 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physician Assistant |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
10734 |
Number Of Medicare Beneficiaries |
1293 |
Total Submitted Charge Amount |
744603.5 |
Total Medicare Allowed Amount |
280925.77 |
Total Medicare Payment Amount |
214715.36 |
Total Medicare Standardized Payment Amount |
241710.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
6012 |
Number Of Medicare Beneficiaries With Drug Services |
105 |
Total Drug Submitted ChargeAmount |
331341.5 |
Total Drug Medicare AllowedAmount |
135605.38 |
Total Drug Medicare PaymentAmount |
105331.38 |
Total Drug Medicare Standardized Payment Amount |
105331.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
46 |
Number Of Medical Services |
4722 |
Number Of Medicare Beneficiaries With Medical Services |
1293 |
Total Medical Submitted Charge Amount |
413262 |
Total Medical Medicare Allowed Amount |
145320.39 |
Total Medical Medicare Payment Amount |
109383.98 |
Total Medical Medicare Standardized Payment Amount |
136379.14 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
150 |
Number Of Beneficiaries Age 65 to 74 |
526 |
Number Of Beneficiaries Age 75 to 84 |
414 |
Number Of Beneficiaries Age Greater 84 |
203 |
Number Of Female Beneficiaries |
387 |
Number Of Male Beneficiaries |
906 |
Number Of Non Hispanic White Beneficiaries |
1222 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
26 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
16 |
Number Of Beneficiaries With Medicare Only Entitlement |
1097 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
196 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
21 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
27 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
34 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2548 |