| National Provider Identifier [NPI]: | 1861490146 |
| Last Name Of The Provider | BROCKMAN |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 519 STATE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW ALBANY |
| Zip Code Of The Provider | 471503620 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 63 |
| Number Of Services | 6620 |
| Number Of Medicare Beneficiaries | 1655 |
| Total Submitted Charge Amount | 5778195.19 |
| Total Medicare Allowed Amount | 1290210.47 |
| Total Medicare Payment Amount | 976899.24 |
| Total Medicare Standardized Payment Amount | 1062008.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 899 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 7204.19 |
| Total Drug Medicare AllowedAmount | 4839.24 |
| Total Drug Medicare PaymentAmount | 3793.98 |
| Total Drug Medicare Standardized Payment Amount | 3793.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 5721 |
| Number Of Medicare Beneficiaries With Medical Services | 1655 |
| Total Medical Submitted Charge Amount | 5770991 |
| Total Medical Medicare Allowed Amount | 1285371.23 |
| Total Medical Medicare Payment Amount | 973105.26 |
| Total Medical Medicare Standardized Payment Amount | 1058214.73 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 164 |
| Number Of Beneficiaries Age 65 to 74 | 831 |
| Number Of Beneficiaries Age 75 to 84 | 519 |
| Number Of Beneficiaries Age Greater 84 | 141 |
| Number Of Female Beneficiaries | 1004 |
| Number Of Male Beneficiaries | 651 |
| Number Of Non Hispanic White Beneficiaries | 1547 |
| Number Of Black or African American Beneficiaries | 79 |
| 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 | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1329 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 326 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0695 |