| National Provider Identifier [NPI]: | 1245378462 |
| Last Name Of The Provider | BROME |
| First Name Of The Provider | WYNFORD |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | PHYSICIAN ASSISTANT |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 150 YORK ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | STOUGHTON |
| Zip Code Of The Provider | 020721829 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 9 |
| Number Of Services | 3484 |
| Number Of Medicare Beneficiaries | 259 |
| Total Submitted Charge Amount | 692830 |
| Total Medicare Allowed Amount | 288372.29 |
| Total Medicare Payment Amount | 225915.65 |
| Total Medicare Standardized Payment Amount | 251148.16 |
| 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 | 9 |
| Number Of Medical Services | 3484 |
| Number Of Medicare Beneficiaries With Medical Services | 259 |
| Total Medical Submitted Charge Amount | 692830 |
| Total Medical Medicare Allowed Amount | 288372.29 |
| Total Medical Medicare Payment Amount | 225915.65 |
| Total Medical Medicare Standardized Payment Amount | 251148.16 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 50 |
| Number Of Beneficiaries Age 75 to 84 | 76 |
| Number Of Beneficiaries Age Greater 84 | 112 |
| Number Of Female Beneficiaries | 148 |
| Number Of Male Beneficiaries | 111 |
| Number Of Non Hispanic White Beneficiaries | 243 |
| Number Of Black or African American Beneficiaries | |
| 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 | 164 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 95 |
| Percent Of With Atrial Fibrillation | 36 |
| Percent Of With Alzheimers Disease or Dementia | 51 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 65 |
| Percent Of With Chronic Kidney Disease | 62 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 49 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 20 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 19 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.9377 |