| National Provider Identifier [NPI]: | 1851463707 |
| Last Name Of The Provider | PACE |
| First Name Of The Provider | BRANTLEY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 713 WATTS ST. |
| Street Address 2 Of The Provider | |
| City Of The Provider | MONTICELLO |
| Zip Code Of The Provider | 39654 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 46 |
| Number Of Services | 10666 |
| Number Of Medicare Beneficiaries | 638 |
| Total Submitted Charge Amount | 957101 |
| Total Medicare Allowed Amount | 651157.58 |
| Total Medicare Payment Amount | 479292.91 |
| Total Medicare Standardized Payment Amount | 494463.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1385 |
| Number Of Medicare Beneficiaries With Drug Services | 448 |
| Total Drug Submitted ChargeAmount | 34755 |
| Total Drug Medicare AllowedAmount | 10959.66 |
| Total Drug Medicare PaymentAmount | 8886.56 |
| Total Drug Medicare Standardized Payment Amount | 8886.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 9281 |
| Number Of Medicare Beneficiaries With Medical Services | 638 |
| Total Medical Submitted Charge Amount | 922346 |
| Total Medical Medicare Allowed Amount | 640197.92 |
| Total Medical Medicare Payment Amount | 470406.35 |
| Total Medical Medicare Standardized Payment Amount | 485577.04 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 112 |
| Number Of Beneficiaries Age 65 to 74 | 219 |
| Number Of Beneficiaries Age 75 to 84 | 228 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 343 |
| Number Of Male Beneficiaries | 295 |
| Number Of Non Hispanic White Beneficiaries | 508 |
| 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 | 425 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 213 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 41 |
| Percent Of With Depression | 54 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 18 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 70 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.5163 |