| National Provider Identifier [NPI]: | 1992886618 |
| Last Name Of The Provider | BRENT |
| First Name Of The Provider | DALE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4955 VAN NUYS BOULEVARD |
| Street Address 2 Of The Provider | SUITE 411 |
| City Of The Provider | SHERMAN OAKS |
| Zip Code Of The Provider | 914031824 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 49 |
| Number Of Services | 10002 |
| Number Of Medicare Beneficiaries | 688 |
| Total Submitted Charge Amount | 1301935 |
| Total Medicare Allowed Amount | 890740.92 |
| Total Medicare Payment Amount | 703740.1 |
| Total Medicare Standardized Payment Amount | 666996.85 |
| 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 | 49 |
| Number Of Medical Services | 10002 |
| Number Of Medicare Beneficiaries With Medical Services | 688 |
| Total Medical Submitted Charge Amount | 1301935 |
| Total Medical Medicare Allowed Amount | 890740.92 |
| Total Medical Medicare Payment Amount | 703740.1 |
| Total Medical Medicare Standardized Payment Amount | 666996.85 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 272 |
| Number Of Beneficiaries Age 65 to 74 | 223 |
| Number Of Beneficiaries Age 75 to 84 | 121 |
| Number Of Beneficiaries Age Greater 84 | 72 |
| Number Of Female Beneficiaries | 317 |
| Number Of Male Beneficiaries | 371 |
| Number Of Non Hispanic White Beneficiaries | 367 |
| Number Of Black or African American Beneficiaries | 116 |
| Number Of AsianPacific Islander Beneficiaries | 31 |
| Number Of Hispanic Beneficiaries | 160 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 60 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 628 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 50 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 49 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 63 |
| Percent Of With Depression | 71 |
| Percent Of With Diabetes | 56 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 74 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 3.053 |