| National Provider Identifier [NPI]: | 1750374591 |
| Last Name Of The Provider | BROAD |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 143 E MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOS GATOS |
| Zip Code Of The Provider | 950306903 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 1286 |
| Number Of Medicare Beneficiaries | 362 |
| Total Submitted Charge Amount | 124340.5 |
| Total Medicare Allowed Amount | 99155.43 |
| Total Medicare Payment Amount | 72156.51 |
| Total Medicare Standardized Payment Amount | 61605.38 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 155 |
| Number Of Medicare Beneficiaries With Drug Services | 130 |
| Total Drug Submitted ChargeAmount | 6948.5 |
| Total Drug Medicare AllowedAmount | 6543.88 |
| Total Drug Medicare PaymentAmount | 6411.4 |
| Total Drug Medicare Standardized Payment Amount | 6411.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 27 |
| Number Of Medical Services | 1131 |
| Number Of Medicare Beneficiaries With Medical Services | 362 |
| Total Medical Submitted Charge Amount | 117392 |
| Total Medical Medicare Allowed Amount | 92611.55 |
| Total Medical Medicare Payment Amount | 65745.11 |
| Total Medical Medicare Standardized Payment Amount | 55193.98 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 169 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 180 |
| Number Of Male Beneficiaries | 182 |
| Number Of Non Hispanic White Beneficiaries | 325 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 15 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 329 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 33 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 46 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 3 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 26 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.8378 |