| National Provider Identifier [NPI]: | 1578590022 |
| Last Name Of The Provider | BROOKS |
| First Name Of The Provider | VICTORIA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | ERIE COUNTY MEDICAL CENTER DEPARTMENT OF PSYCHIATRY |
| Street Address 2 Of The Provider | 462 GRIDER ST |
| City Of The Provider | BUFFALO |
| Zip Code Of The Provider | 14215 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Geriatric Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 2 |
| Number Of Services | 206 |
| Number Of Medicare Beneficiaries | 177 |
| Total Submitted Charge Amount | 41200 |
| Total Medicare Allowed Amount | 28302.3 |
| Total Medicare Payment Amount | 21344.51 |
| Total Medicare Standardized Payment Amount | 21866.84 |
| 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 | 2 |
| Number Of Medical Services | 206 |
| Number Of Medicare Beneficiaries With Medical Services | 177 |
| Total Medical Submitted Charge Amount | 41200 |
| Total Medical Medicare Allowed Amount | 28302.3 |
| Total Medical Medicare Payment Amount | 21344.51 |
| Total Medical Medicare Standardized Payment Amount | 21866.84 |
| Average Age Of Beneficiaries | 50 |
| Number Of Beneficiaries Age Less65 | 147 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 78 |
| Number Of Male Beneficiaries | 99 |
| Number Of Non Hispanic White Beneficiaries | 111 |
| Number Of Black or African American Beneficiaries | 54 |
| 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 | 31 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 146 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 58 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 32 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 18 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 16 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 75 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2941 |