| National Provider Identifier [NPI]: | 1457404170 |
| Last Name Of The Provider | AUGUSTINE |
| First Name Of The Provider | BRANDY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 895 CANTON RD NE |
| Street Address 2 Of The Provider | #100 |
| City Of The Provider | MARIETTA |
| Zip Code Of The Provider | 300608934 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 453 |
| Number Of Medicare Beneficiaries | 321 |
| Total Submitted Charge Amount | 60028 |
| Total Medicare Allowed Amount | 46168.8 |
| Total Medicare Payment Amount | 30908.09 |
| Total Medicare Standardized Payment Amount | 30900.13 |
| 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 | 16 |
| Number Of Medical Services | 453 |
| Number Of Medicare Beneficiaries With Medical Services | 321 |
| Total Medical Submitted Charge Amount | 60028 |
| Total Medical Medicare Allowed Amount | 46168.8 |
| Total Medical Medicare Payment Amount | 30908.09 |
| Total Medical Medicare Standardized Payment Amount | 30900.13 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 176 |
| Number Of Beneficiaries Age 75 to 84 | 101 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 201 |
| Number Of Male Beneficiaries | 120 |
| Number Of Non Hispanic White Beneficiaries | 259 |
| Number Of Black or African American Beneficiaries | 42 |
| 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 | 287 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 7 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9258 |