| National Provider Identifier [NPI]: | 1518929439 |
| Last Name Of The Provider | BREWER |
| First Name Of The Provider | JACK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2090 NE WYATT CT |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | BEND |
| Zip Code Of The Provider | 977017687 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 4955 |
| Number Of Medicare Beneficiaries | 995 |
| Total Submitted Charge Amount | 1435924.69 |
| Total Medicare Allowed Amount | 349059.51 |
| Total Medicare Payment Amount | 254813.59 |
| Total Medicare Standardized Payment Amount | 263714.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 371 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 138846.85 |
| Total Drug Medicare AllowedAmount | 50693.46 |
| Total Drug Medicare PaymentAmount | 39225.37 |
| Total Drug Medicare Standardized Payment Amount | 39225.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 88 |
| Number Of Medical Services | 4584 |
| Number Of Medicare Beneficiaries With Medical Services | 994 |
| Total Medical Submitted Charge Amount | 1297077.84 |
| Total Medical Medicare Allowed Amount | 298366.05 |
| Total Medical Medicare Payment Amount | 215588.22 |
| Total Medical Medicare Standardized Payment Amount | 224489.59 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 484 |
| Number Of Beneficiaries Age 75 to 84 | 360 |
| Number Of Beneficiaries Age Greater 84 | 103 |
| Number Of Female Beneficiaries | 108 |
| Number Of Male Beneficiaries | 887 |
| Number Of Non Hispanic White Beneficiaries | 940 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 19 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 928 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 32 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9719 |