| National Provider Identifier [NPI]: | 1922164755 |
| Last Name Of The Provider | BROCHU |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | U-MASS MEMORIAL MEDICAL CENTER |
| Street Address 2 Of The Provider | 55 LAKE AVENUE NORTH |
| City Of The Provider | WORCESTER |
| Zip Code Of The Provider | 01655 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 137 |
| Number Of Services | 4913 |
| Number Of Medicare Beneficiaries | 2574 |
| Total Submitted Charge Amount | 354809 |
| Total Medicare Allowed Amount | 116368.31 |
| Total Medicare Payment Amount | 91448.52 |
| Total Medicare Standardized Payment Amount | 89424.88 |
| 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 | 137 |
| Number Of Medical Services | 4913 |
| Number Of Medicare Beneficiaries With Medical Services | 2574 |
| Total Medical Submitted Charge Amount | 354809 |
| Total Medical Medicare Allowed Amount | 116368.31 |
| Total Medical Medicare Payment Amount | 91448.52 |
| Total Medical Medicare Standardized Payment Amount | 89424.88 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 473 |
| Number Of Beneficiaries Age 65 to 74 | 973 |
| Number Of Beneficiaries Age 75 to 84 | 673 |
| Number Of Beneficiaries Age Greater 84 | 455 |
| Number Of Female Beneficiaries | 1749 |
| Number Of Male Beneficiaries | 825 |
| Number Of Non Hispanic White Beneficiaries | 2363 |
| Number Of Black or African American Beneficiaries | 40 |
| Number Of AsianPacific Islander Beneficiaries | 25 |
| Number Of Hispanic Beneficiaries | 107 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 39 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1849 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 725 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3221 |