| National Provider Identifier [NPI]: | 1912036823 |
| Last Name Of The Provider | BROCK |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 136 MARION AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MCCOMB |
| Zip Code Of The Provider | 396483620 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 4241 |
| Number Of Medicare Beneficiaries | 1215 |
| Total Submitted Charge Amount | 519225 |
| Total Medicare Allowed Amount | 301920.96 |
| Total Medicare Payment Amount | 210855.58 |
| Total Medicare Standardized Payment Amount | 232918.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 439 |
| Number Of Medicare Beneficiaries With Drug Services | 69 |
| Total Drug Submitted ChargeAmount | 3073 |
| Total Drug Medicare AllowedAmount | 783.88 |
| Total Drug Medicare PaymentAmount | 499.26 |
| Total Drug Medicare Standardized Payment Amount | 499.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 64 |
| Number Of Medical Services | 3802 |
| Number Of Medicare Beneficiaries With Medical Services | 1215 |
| Total Medical Submitted Charge Amount | 516152 |
| Total Medical Medicare Allowed Amount | 301137.08 |
| Total Medical Medicare Payment Amount | 210356.32 |
| Total Medical Medicare Standardized Payment Amount | 232419.52 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 488 |
| Number Of Beneficiaries Age 75 to 84 | 439 |
| Number Of Beneficiaries Age Greater 84 | 214 |
| Number Of Female Beneficiaries | 547 |
| Number Of Male Beneficiaries | 668 |
| Number Of Non Hispanic White Beneficiaries | 1134 |
| Number Of Black or African American Beneficiaries | 67 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1120 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 95 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0327 |