| National Provider Identifier [NPI]: | 1033349170 |
| Last Name Of The Provider | LOVELL |
| First Name Of The Provider | BRIGITTE |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | DMD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1202 MARICOPA HWY |
| Street Address 2 Of The Provider | STE A |
| City Of The Provider | OJAI |
| Zip Code Of The Provider | 930233169 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Oral Surgery (dentists only) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 4216 |
| Number Of Medicare Beneficiaries | 117 |
| Total Submitted Charge Amount | 212010 |
| Total Medicare Allowed Amount | 134141.35 |
| Total Medicare Payment Amount | 101106.9 |
| Total Medicare Standardized Payment Amount | 95095.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 3460 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 25720 |
| Total Drug Medicare AllowedAmount | 18839.29 |
| Total Drug Medicare PaymentAmount | 14770.03 |
| Total Drug Medicare Standardized Payment Amount | 14770.03 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 19 |
| Number Of Medical Services | 756 |
| Number Of Medicare Beneficiaries With Medical Services | 117 |
| Total Medical Submitted Charge Amount | 186290 |
| Total Medical Medicare Allowed Amount | 115302.06 |
| Total Medical Medicare Payment Amount | 86336.87 |
| Total Medical Medicare Standardized Payment Amount | 80325.58 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 55 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 86 |
| Number Of Male Beneficiaries | 31 |
| Number Of Non Hispanic White Beneficiaries | 94 |
| 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 | 81 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9429 |