| National Provider Identifier [NPI]: | 1619174612 |
| Last Name Of The Provider | IRWIN |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 COLCHESTER AVE. ACC/ EP5 |
| Street Address 2 Of The Provider | FAHC UROLOGY |
| City Of The Provider | BURLINGTON |
| Zip Code Of The Provider | 05401 |
| State Code Of The Provider | VT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 1434 |
| Number Of Medicare Beneficiaries | 569 |
| Total Submitted Charge Amount | 824191 |
| Total Medicare Allowed Amount | 172429.03 |
| Total Medicare Payment Amount | 128671.38 |
| Total Medicare Standardized Payment Amount | 130827.37 |
| 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 | 68 |
| Number Of Medical Services | 1434 |
| Number Of Medicare Beneficiaries With Medical Services | 569 |
| Total Medical Submitted Charge Amount | 824191 |
| Total Medical Medicare Allowed Amount | 172429.03 |
| Total Medical Medicare Payment Amount | 128671.38 |
| Total Medical Medicare Standardized Payment Amount | 130827.37 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 63 |
| Number Of Beneficiaries Age 65 to 74 | 289 |
| Number Of Beneficiaries Age 75 to 84 | 161 |
| Number Of Beneficiaries Age Greater 84 | 56 |
| Number Of Female Beneficiaries | 96 |
| Number Of Male Beneficiaries | 473 |
| Number Of Non Hispanic White Beneficiaries | 539 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 495 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 74 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 34 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 2 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0646 |