| National Provider Identifier [NPI]: | 1265443436 |
| Last Name Of The Provider | BRANDON |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 PROFESSIONAL PARK PVT DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | KINGSPORT |
| Zip Code Of The Provider | 376632288 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 86 |
| Number Of Services | 2436 |
| Number Of Medicare Beneficiaries | 201 |
| Total Submitted Charge Amount | 165470.5 |
| Total Medicare Allowed Amount | 68651.49 |
| Total Medicare Payment Amount | 49999.72 |
| Total Medicare Standardized Payment Amount | 53685.26 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 190 |
| Number Of Medicare Beneficiaries With Drug Services | 102 |
| Total Drug Submitted ChargeAmount | 7424.5 |
| Total Drug Medicare AllowedAmount | 4615.22 |
| Total Drug Medicare PaymentAmount | 4345.27 |
| Total Drug Medicare Standardized Payment Amount | 4345.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 78 |
| Number Of Medical Services | 2246 |
| Number Of Medicare Beneficiaries With Medical Services | 201 |
| Total Medical Submitted Charge Amount | 158046 |
| Total Medical Medicare Allowed Amount | 64036.27 |
| Total Medical Medicare Payment Amount | 45654.45 |
| Total Medical Medicare Standardized Payment Amount | 49339.99 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 104 |
| Number Of Beneficiaries Age 75 to 84 | 48 |
| Number Of Beneficiaries Age Greater 84 | 23 |
| Number Of Female Beneficiaries | 106 |
| Number Of Male Beneficiaries | 95 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 185 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 16 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8205 |