| National Provider Identifier [NPI]: | 1073624573 |
| Last Name Of The Provider | BRAKER |
| First Name Of The Provider | LAURIE |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4294 LAUREL DR |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAKE ODESSA |
| Zip Code Of The Provider | 488499423 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 47 |
| Number Of Services | 991 |
| Number Of Medicare Beneficiaries | 171 |
| Total Submitted Charge Amount | 106335.5 |
| Total Medicare Allowed Amount | 65753.03 |
| Total Medicare Payment Amount | 51052.6 |
| Total Medicare Standardized Payment Amount | 54614.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 218 |
| Number Of Medicare Beneficiaries With Drug Services | 91 |
| Total Drug Submitted ChargeAmount | 13031.5 |
| Total Drug Medicare AllowedAmount | 7979.18 |
| Total Drug Medicare PaymentAmount | 7644.11 |
| Total Drug Medicare Standardized Payment Amount | 7644.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 773 |
| Number Of Medicare Beneficiaries With Medical Services | 171 |
| Total Medical Submitted Charge Amount | 93304 |
| Total Medical Medicare Allowed Amount | 57773.85 |
| Total Medical Medicare Payment Amount | 43408.49 |
| Total Medical Medicare Standardized Payment Amount | 46970.63 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 39 |
| Number Of Beneficiaries Age 65 to 74 | 62 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 27 |
| Number Of Female Beneficiaries | 125 |
| Number Of Male Beneficiaries | 46 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 132 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 68 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0188 |