| National Provider Identifier [NPI]: | 1114173937 |
| Last Name Of The Provider | BROUHA |
| First Name Of The Provider | BROOK |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD/PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7300 GIRARD AVE |
| Street Address 2 Of The Provider | SUITE 104 |
| City Of The Provider | LA JOLLA |
| Zip Code Of The Provider | 920375138 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 7322 |
| Number Of Medicare Beneficiaries | 1142 |
| Total Submitted Charge Amount | 601756.7 |
| Total Medicare Allowed Amount | 388843.06 |
| Total Medicare Payment Amount | 285456.25 |
| Total Medicare Standardized Payment Amount | 273526.53 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 143 |
| Number Of Medicare Beneficiaries With Drug Services | 55 |
| Total Drug Submitted ChargeAmount | 10035 |
| Total Drug Medicare AllowedAmount | 9093.72 |
| Total Drug Medicare PaymentAmount | 6836.02 |
| Total Drug Medicare Standardized Payment Amount | 6836.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 7179 |
| Number Of Medicare Beneficiaries With Medical Services | 1142 |
| Total Medical Submitted Charge Amount | 591721.7 |
| Total Medical Medicare Allowed Amount | 379749.34 |
| Total Medical Medicare Payment Amount | 278620.23 |
| Total Medical Medicare Standardized Payment Amount | 266690.51 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 525 |
| Number Of Beneficiaries Age 75 to 84 | 346 |
| Number Of Beneficiaries Age Greater 84 | 236 |
| Number Of Female Beneficiaries | 598 |
| Number Of Male Beneficiaries | 544 |
| Number Of Non Hispanic White Beneficiaries | 1048 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 49 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1083 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 59 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 18 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0196 |