| National Provider Identifier [NPI]: | 1972614238 |
| Last Name Of The Provider | BRY |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 365 HAWTHORNE AVE |
| Street Address 2 Of The Provider | STE 103 |
| City Of The Provider | OAKLAND |
| Zip Code Of The Provider | 946093107 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 3506 |
| Number Of Medicare Beneficiaries | 408 |
| Total Submitted Charge Amount | 2266555 |
| Total Medicare Allowed Amount | 592902.45 |
| Total Medicare Payment Amount | 453304 |
| Total Medicare Standardized Payment Amount | 397437.83 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1767 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 1961 |
| Total Drug Medicare AllowedAmount | 335.36 |
| Total Drug Medicare PaymentAmount | 260.39 |
| Total Drug Medicare Standardized Payment Amount | 260.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 1739 |
| Number Of Medicare Beneficiaries With Medical Services | 408 |
| Total Medical Submitted Charge Amount | 2264594 |
| Total Medical Medicare Allowed Amount | 592567.09 |
| Total Medical Medicare Payment Amount | 453043.61 |
| Total Medical Medicare Standardized Payment Amount | 397177.44 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 146 |
| Number Of Beneficiaries Age 65 to 74 | 118 |
| Number Of Beneficiaries Age 75 to 84 | 105 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 195 |
| Number Of Male Beneficiaries | 213 |
| Number Of Non Hispanic White Beneficiaries | 158 |
| Number Of Black or African American Beneficiaries | 120 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 64 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 185 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 223 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 25 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 5.4676 |