| National Provider Identifier [NPI]: | 1932141413 |
| Last Name Of The Provider | BRAKEBILL |
| First Name Of The Provider | LARRY |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7557B DANNAHER WAY |
| Street Address 2 Of The Provider | SUITE 225 |
| City Of The Provider | POWELL |
| Zip Code Of The Provider | 378493568 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 130 |
| Number Of Services | 7687 |
| Number Of Medicare Beneficiaries | 460 |
| Total Submitted Charge Amount | 455691 |
| Total Medicare Allowed Amount | 231367.86 |
| Total Medicare Payment Amount | 182342.65 |
| Total Medicare Standardized Payment Amount | 194717.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 312 |
| Number Of Medicare Beneficiaries With Drug Services | 229 |
| Total Drug Submitted ChargeAmount | 8763 |
| Total Drug Medicare AllowedAmount | 6895.98 |
| Total Drug Medicare PaymentAmount | 6629.6 |
| Total Drug Medicare Standardized Payment Amount | 6629.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 117 |
| Number Of Medical Services | 7375 |
| Number Of Medicare Beneficiaries With Medical Services | 460 |
| Total Medical Submitted Charge Amount | 446928 |
| Total Medical Medicare Allowed Amount | 224471.88 |
| Total Medical Medicare Payment Amount | 175713.05 |
| Total Medical Medicare Standardized Payment Amount | 188088.15 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 198 |
| Number Of Beneficiaries Age 75 to 84 | 142 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 257 |
| Number Of Male Beneficiaries | 203 |
| Number Of Non Hispanic White Beneficiaries | 433 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 421 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.977 |