| National Provider Identifier [NPI]: | 1992791826 |
| Last Name Of The Provider | BRODY |
| First Name Of The Provider | GORDON |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1001 N WALDROP DR |
| Street Address 2 Of The Provider | SUITE 708 |
| City Of The Provider | ARLINGTON |
| Zip Code Of The Provider | 760124705 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 519 |
| Number Of Medicare Beneficiaries | 250 |
| Total Submitted Charge Amount | 140323 |
| Total Medicare Allowed Amount | 42070.67 |
| Total Medicare Payment Amount | 28865.93 |
| Total Medicare Standardized Payment Amount | 30436.53 |
| 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 | 25 |
| Number Of Medical Services | 519 |
| Number Of Medicare Beneficiaries With Medical Services | 250 |
| Total Medical Submitted Charge Amount | 140323 |
| Total Medical Medicare Allowed Amount | 42070.67 |
| Total Medical Medicare Payment Amount | 28865.93 |
| Total Medical Medicare Standardized Payment Amount | 30436.53 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 18 |
| Number Of Male Beneficiaries | 232 |
| Number Of Non Hispanic White Beneficiaries | 209 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 239 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 41 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.047 |