| National Provider Identifier [NPI]: | 1558412130 |
| Last Name Of The Provider | WOODBURY |
| First Name Of The Provider | BRENT |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5409 AVENUE O |
| Street Address 2 Of The Provider | |
| City Of The Provider | FORT MADISON |
| Zip Code Of The Provider | 526279601 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 134 |
| Number Of Services | 2233 |
| Number Of Medicare Beneficiaries | 342 |
| Total Submitted Charge Amount | 1319251 |
| Total Medicare Allowed Amount | 221555.94 |
| Total Medicare Payment Amount | 168596.55 |
| Total Medicare Standardized Payment Amount | 186432.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 875 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 88205 |
| Total Drug Medicare AllowedAmount | 7095.34 |
| Total Drug Medicare PaymentAmount | 5511.55 |
| Total Drug Medicare Standardized Payment Amount | 5511.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 130 |
| Number Of Medical Services | 1358 |
| Number Of Medicare Beneficiaries With Medical Services | 342 |
| Total Medical Submitted Charge Amount | 1231046 |
| Total Medical Medicare Allowed Amount | 214460.6 |
| Total Medical Medicare Payment Amount | 163085 |
| Total Medical Medicare Standardized Payment Amount | 180921.33 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 159 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 50 |
| Number Of Female Beneficiaries | 216 |
| Number Of Male Beneficiaries | 126 |
| Number Of Non Hispanic White Beneficiaries | 327 |
| 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 | 283 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 64 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0163 |