| National Provider Identifier [NPI]: | 1326021973 |
| Last Name Of The Provider | STORM |
| First Name Of The Provider | BRETT |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1900 FAIRVIEW AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOTHAN |
| Zip Code Of The Provider | 363013008 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 281 |
| Number Of Services | 9005 |
| Number Of Medicare Beneficiaries | 5673 |
| Total Submitted Charge Amount | 1622043 |
| Total Medicare Allowed Amount | 315225.86 |
| Total Medicare Payment Amount | 239292.85 |
| Total Medicare Standardized Payment Amount | 252947.94 |
| 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 | 281 |
| Number Of Medical Services | 9005 |
| Number Of Medicare Beneficiaries With Medical Services | 5673 |
| Total Medical Submitted Charge Amount | 1622043 |
| Total Medical Medicare Allowed Amount | 315225.86 |
| Total Medical Medicare Payment Amount | 239292.85 |
| Total Medical Medicare Standardized Payment Amount | 252947.94 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 1330 |
| Number Of Beneficiaries Age 65 to 74 | 2000 |
| Number Of Beneficiaries Age 75 to 84 | 1660 |
| Number Of Beneficiaries Age Greater 84 | 683 |
| Number Of Female Beneficiaries | 3223 |
| Number Of Male Beneficiaries | 2450 |
| Number Of Non Hispanic White Beneficiaries | 4417 |
| Number Of Black or African American Beneficiaries | 1150 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 30 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3825 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1848 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6424 |