| National Provider Identifier [NPI]: | 1740399245 |
| Last Name Of The Provider | BRONNER |
| First Name Of The Provider | ANNE |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 SKOKIE BLVD |
| Street Address 2 Of The Provider | SUITE 475 |
| City Of The Provider | NORTHBROOK |
| Zip Code Of The Provider | 600627930 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 37 |
| Number Of Services | 3362 |
| Number Of Medicare Beneficiaries | 726 |
| Total Submitted Charge Amount | 179920 |
| Total Medicare Allowed Amount | 165833.3 |
| Total Medicare Payment Amount | 116988.55 |
| Total Medicare Standardized Payment Amount | 106240.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 23 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 5950 |
| Total Drug Medicare AllowedAmount | 5429.4 |
| Total Drug Medicare PaymentAmount | 4222.74 |
| Total Drug Medicare Standardized Payment Amount | 4222.74 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 3339 |
| Number Of Medicare Beneficiaries With Medical Services | 726 |
| Total Medical Submitted Charge Amount | 173970 |
| Total Medical Medicare Allowed Amount | 160403.9 |
| Total Medical Medicare Payment Amount | 112765.81 |
| Total Medical Medicare Standardized Payment Amount | 102017.94 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 351 |
| Number Of Beneficiaries Age 75 to 84 | 257 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 568 |
| Number Of Male Beneficiaries | 158 |
| Number Of Non Hispanic White Beneficiaries | 702 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 3 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 6 |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 9 |
| Percent Of With Diabetes | 11 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.7865 |