| National Provider Identifier [NPI]: | 1144229535 |
| Last Name Of The Provider | VANDERBROEK |
| First Name Of The Provider | MARCIA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | DO |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3272 WEST RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TRENTON |
| Zip Code Of The Provider | 481832322 |
| 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 | 43 |
| Number Of Services | 1308 |
| Number Of Medicare Beneficiaries | 144 |
| Total Submitted Charge Amount | 89811 |
| Total Medicare Allowed Amount | 70515.88 |
| Total Medicare Payment Amount | 51909.51 |
| Total Medicare Standardized Payment Amount | 51065.88 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 175 |
| Number Of Medicare Beneficiaries With Drug Services | 83 |
| Total Drug Submitted ChargeAmount | 4058 |
| Total Drug Medicare AllowedAmount | 2442.59 |
| Total Drug Medicare PaymentAmount | 2334.79 |
| Total Drug Medicare Standardized Payment Amount | 2334.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 1133 |
| Number Of Medicare Beneficiaries With Medical Services | 144 |
| Total Medical Submitted Charge Amount | 85753 |
| Total Medical Medicare Allowed Amount | 68073.29 |
| Total Medical Medicare Payment Amount | 49574.72 |
| Total Medical Medicare Standardized Payment Amount | 48731.09 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 20 |
| Number Of Beneficiaries Age 65 to 74 | 67 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | 26 |
| Number Of Female Beneficiaries | 97 |
| Number Of Male Beneficiaries | 47 |
| 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 | 133 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 11 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 10 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1471 |