| National Provider Identifier [NPI]: | 1841510765 |
| Last Name Of The Provider | BRANDT |
| First Name Of The Provider | SEAN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5629 STADIUM DR |
| Street Address 2 Of The Provider | SUITE D |
| City Of The Provider | KALAMAZOO |
| Zip Code Of The Provider | 490091952 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 610 |
| Number Of Medicare Beneficiaries | 172 |
| Total Submitted Charge Amount | 69714 |
| Total Medicare Allowed Amount | 47277.37 |
| Total Medicare Payment Amount | 34672.67 |
| Total Medicare Standardized Payment Amount | 36839.7 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 73 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 3909 |
| Total Drug Medicare AllowedAmount | 3299.55 |
| Total Drug Medicare PaymentAmount | 3232.42 |
| Total Drug Medicare Standardized Payment Amount | 3232.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 537 |
| Number Of Medicare Beneficiaries With Medical Services | 172 |
| Total Medical Submitted Charge Amount | 65805 |
| Total Medical Medicare Allowed Amount | 43977.82 |
| Total Medical Medicare Payment Amount | 31440.25 |
| Total Medical Medicare Standardized Payment Amount | 33607.28 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 29 |
| Number Of Beneficiaries Age 65 to 74 | 71 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 111 |
| Number Of Male Beneficiaries | 61 |
| Number Of Non Hispanic White Beneficiaries | 160 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 158 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9134 |