| National Provider Identifier [NPI]: | 1871561035 |
| Last Name Of The Provider | BENNETT |
| First Name Of The Provider | BRENT |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2300 LOHMANS SPUR |
| Street Address 2 Of The Provider | #106 |
| City Of The Provider | LAKEWAY |
| Zip Code Of The Provider | 787346206 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 5225 |
| Number Of Medicare Beneficiaries | 1347 |
| Total Submitted Charge Amount | 442752 |
| Total Medicare Allowed Amount | 301506.09 |
| Total Medicare Payment Amount | 215714.22 |
| Total Medicare Standardized Payment Amount | 220683.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 189 |
| Number Of Medicare Beneficiaries With Drug Services | 121 |
| Total Drug Submitted ChargeAmount | 6790 |
| Total Drug Medicare AllowedAmount | 819.68 |
| Total Drug Medicare PaymentAmount | 536.15 |
| Total Drug Medicare Standardized Payment Amount | 536.15 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 5036 |
| Number Of Medicare Beneficiaries With Medical Services | 1347 |
| Total Medical Submitted Charge Amount | 435962 |
| Total Medical Medicare Allowed Amount | 300686.41 |
| Total Medical Medicare Payment Amount | 215178.07 |
| Total Medical Medicare Standardized Payment Amount | 220147.15 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 731 |
| Number Of Beneficiaries Age 75 to 84 | 400 |
| Number Of Beneficiaries Age Greater 84 | 163 |
| Number Of Female Beneficiaries | 716 |
| Number Of Male Beneficiaries | 631 |
| Number Of Non Hispanic White Beneficiaries | 1276 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 23 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1321 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 26 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 16 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 47 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8424 |