| National Provider Identifier [NPI]: | 1003002742 |
| Last Name Of The Provider | LOCKMAN |
| First Name Of The Provider | BRETT |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4550 E 53RD ST |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | DAVENPORT |
| Zip Code Of The Provider | 528073171 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physical Medicine and Rehabilitation |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 5186 |
| Number Of Medicare Beneficiaries | 134 |
| Total Submitted Charge Amount | 693637 |
| Total Medicare Allowed Amount | 189105.47 |
| Total Medicare Payment Amount | 150126.29 |
| Total Medicare Standardized Payment Amount | 153489.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 2957 |
| Number Of Medicare Beneficiaries With Drug Services | 89 |
| Total Drug Submitted ChargeAmount | 51139 |
| Total Drug Medicare AllowedAmount | 15969.27 |
| Total Drug Medicare PaymentAmount | 12455.9 |
| Total Drug Medicare Standardized Payment Amount | 12455.9 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 2229 |
| Number Of Medicare Beneficiaries With Medical Services | 134 |
| Total Medical Submitted Charge Amount | 642498 |
| Total Medical Medicare Allowed Amount | 173136.2 |
| Total Medical Medicare Payment Amount | 137670.39 |
| Total Medical Medicare Standardized Payment Amount | 141033.64 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 72 |
| Number Of Beneficiaries Age 65 to 74 | 31 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 89 |
| Number Of Male Beneficiaries | 45 |
| Number Of Non Hispanic White Beneficiaries | 123 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 80 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.3086 |