| National Provider Identifier [NPI]: | 1164431078 |
| Last Name Of The Provider | BRACKIN |
| First Name Of The Provider | JACK |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1209 HIGHWAY 35 N |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | ROCKPORT |
| Zip Code Of The Provider | 783823117 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 8040 |
| Number Of Medicare Beneficiaries | 1065 |
| Total Submitted Charge Amount | 615604 |
| Total Medicare Allowed Amount | 443105.12 |
| Total Medicare Payment Amount | 308119.6 |
| Total Medicare Standardized Payment Amount | 328044 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 2528 |
| Number Of Medicare Beneficiaries With Drug Services | 490 |
| Total Drug Submitted ChargeAmount | 29807 |
| Total Drug Medicare AllowedAmount | 16191.22 |
| Total Drug Medicare PaymentAmount | 14607.23 |
| Total Drug Medicare Standardized Payment Amount | 14607.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 63 |
| Number Of Medical Services | 5512 |
| Number Of Medicare Beneficiaries With Medical Services | 1064 |
| Total Medical Submitted Charge Amount | 585797 |
| Total Medical Medicare Allowed Amount | 426913.9 |
| Total Medical Medicare Payment Amount | 293512.37 |
| Total Medical Medicare Standardized Payment Amount | 313436.77 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 108 |
| Number Of Beneficiaries Age 65 to 74 | 526 |
| Number Of Beneficiaries Age 75 to 84 | 340 |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 537 |
| Number Of Male Beneficiaries | 528 |
| Number Of Non Hispanic White Beneficiaries | 948 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 83 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 937 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 128 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9601 |