| National Provider Identifier [NPI]: | 1922061373 |
| Last Name Of The Provider | BROCKSMITH |
| First Name Of The Provider | JAMES |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1705 E BROADWAY |
| Street Address 2 Of The Provider | SUITE 220 |
| City Of The Provider | COLUMBIA |
| Zip Code Of The Provider | 652017166 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 5874 |
| Number Of Medicare Beneficiaries | 1487 |
| Total Submitted Charge Amount | 1043321 |
| Total Medicare Allowed Amount | 532521.14 |
| Total Medicare Payment Amount | 382382.2 |
| Total Medicare Standardized Payment Amount | 338670.57 |
| 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 | 34 |
| Number Of Medical Services | 5874 |
| Number Of Medicare Beneficiaries With Medical Services | 1487 |
| Total Medical Submitted Charge Amount | 1043321 |
| Total Medical Medicare Allowed Amount | 532521.14 |
| Total Medical Medicare Payment Amount | 382382.2 |
| Total Medical Medicare Standardized Payment Amount | 338670.57 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 95 |
| Number Of Beneficiaries Age 65 to 74 | 731 |
| Number Of Beneficiaries Age 75 to 84 | 496 |
| Number Of Beneficiaries Age Greater 84 | 165 |
| Number Of Female Beneficiaries | 841 |
| Number Of Male Beneficiaries | 646 |
| Number Of Non Hispanic White Beneficiaries | 1436 |
| Number Of Black or African American Beneficiaries | 25 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1409 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 78 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 72 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0188 |