| National Provider Identifier [NPI]: | 1811282346 |
| Last Name Of The Provider | ENGELBRECHT |
| First Name Of The Provider | JOHANNES |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 30 BUCHANAN BYP |
| Street Address 2 Of The Provider | |
| City Of The Provider | BUCHANAN |
| Zip Code Of The Provider | 301134924 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 22 |
| Number Of Services | 477 |
| Number Of Medicare Beneficiaries | 104 |
| Total Submitted Charge Amount | 31393 |
| Total Medicare Allowed Amount | 18669.37 |
| Total Medicare Payment Amount | 14054.41 |
| Total Medicare Standardized Payment Amount | 14934.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 213 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 1244 |
| Total Drug Medicare AllowedAmount | 176.41 |
| Total Drug Medicare PaymentAmount | 154.44 |
| Total Drug Medicare Standardized Payment Amount | 154.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 16 |
| Number Of Medical Services | 264 |
| Number Of Medicare Beneficiaries With Medical Services | 104 |
| Total Medical Submitted Charge Amount | 30149 |
| Total Medical Medicare Allowed Amount | 18492.96 |
| Total Medical Medicare Payment Amount | 13899.97 |
| Total Medical Medicare Standardized Payment Amount | 14780.36 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 51 |
| Number Of Beneficiaries Age 75 to 84 | 22 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 66 |
| Number Of Male Beneficiaries | 38 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 71 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.329 |