| National Provider Identifier [NPI]: | 1639369432 |
| Last Name Of The Provider | PRIVETT |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1650 1ST AVE NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CEDAR RAPIDS |
| Zip Code Of The Provider | 524025431 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 3399 |
| Number Of Medicare Beneficiaries | 725 |
| Total Submitted Charge Amount | 1143481 |
| Total Medicare Allowed Amount | 649491.87 |
| Total Medicare Payment Amount | 497054.55 |
| Total Medicare Standardized Payment Amount | 508085.33 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 855 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 514800 |
| Total Drug Medicare AllowedAmount | 409271.82 |
| Total Drug Medicare PaymentAmount | 320815.49 |
| Total Drug Medicare Standardized Payment Amount | 320815.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 2544 |
| Number Of Medicare Beneficiaries With Medical Services | 725 |
| Total Medical Submitted Charge Amount | 628681 |
| Total Medical Medicare Allowed Amount | 240220.05 |
| Total Medical Medicare Payment Amount | 176239.06 |
| Total Medical Medicare Standardized Payment Amount | 187269.84 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 290 |
| Number Of Beneficiaries Age 75 to 84 | 234 |
| Number Of Beneficiaries Age Greater 84 | 139 |
| Number Of Female Beneficiaries | 433 |
| Number Of Male Beneficiaries | 292 |
| Number Of Non Hispanic White Beneficiaries | 694 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 625 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 100 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0896 |