| National Provider Identifier [NPI]: | 1821056318 |
| Last Name Of The Provider | BROUILLETTE |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 817 PRINCETON AVE SW |
| Street Address 2 Of The Provider | SUITE 210 |
| City Of The Provider | BIRMINGHAM |
| Zip Code Of The Provider | 352111348 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 21046 |
| Number Of Medicare Beneficiaries | 876 |
| Total Submitted Charge Amount | 1840121.25 |
| Total Medicare Allowed Amount | 720655.75 |
| Total Medicare Payment Amount | 555809.61 |
| Total Medicare Standardized Payment Amount | 611909.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 17473 |
| Number Of Medicare Beneficiaries With Drug Services | 255 |
| Total Drug Submitted ChargeAmount | 104303 |
| Total Drug Medicare AllowedAmount | 50603.82 |
| Total Drug Medicare PaymentAmount | 38003.57 |
| Total Drug Medicare Standardized Payment Amount | 38003.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 3573 |
| Number Of Medicare Beneficiaries With Medical Services | 875 |
| Total Medical Submitted Charge Amount | 1735818.25 |
| Total Medical Medicare Allowed Amount | 670051.93 |
| Total Medical Medicare Payment Amount | 517806.04 |
| Total Medical Medicare Standardized Payment Amount | 573906.35 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 307 |
| Number Of Beneficiaries Age 65 to 74 | 276 |
| Number Of Beneficiaries Age 75 to 84 | 210 |
| Number Of Beneficiaries Age Greater 84 | 83 |
| Number Of Female Beneficiaries | 433 |
| Number Of Male Beneficiaries | 443 |
| Number Of Non Hispanic White Beneficiaries | 413 |
| Number Of Black or African American Beneficiaries | 449 |
| 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 | 606 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 270 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 64 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 68 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 5.416 |