| National Provider Identifier [NPI]: | 1255361762 |
| Last Name Of The Provider | BRUNNER |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7253 AMBASSADOR RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212442710 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 151 |
| Number Of Services | 34977 |
| Number Of Medicare Beneficiaries | 3887 |
| Total Submitted Charge Amount | 1448112.52 |
| Total Medicare Allowed Amount | 422131.19 |
| Total Medicare Payment Amount | 321709.06 |
| Total Medicare Standardized Payment Amount | 307523.27 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 29609 |
| Number Of Medicare Beneficiaries With Drug Services | 302 |
| Total Drug Submitted ChargeAmount | 7283.51 |
| Total Drug Medicare AllowedAmount | 5855.39 |
| Total Drug Medicare PaymentAmount | 4376.38 |
| Total Drug Medicare Standardized Payment Amount | 4376.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 149 |
| Number Of Medical Services | 5368 |
| Number Of Medicare Beneficiaries With Medical Services | 3887 |
| Total Medical Submitted Charge Amount | 1440829.01 |
| Total Medical Medicare Allowed Amount | 416275.8 |
| Total Medical Medicare Payment Amount | 317332.68 |
| Total Medical Medicare Standardized Payment Amount | 303146.89 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 688 |
| Number Of Beneficiaries Age 65 to 74 | 1563 |
| Number Of Beneficiaries Age 75 to 84 | 1124 |
| Number Of Beneficiaries Age Greater 84 | 512 |
| Number Of Female Beneficiaries | 2390 |
| Number Of Male Beneficiaries | 1497 |
| Number Of Non Hispanic White Beneficiaries | 3261 |
| Number Of Black or African American Beneficiaries | 469 |
| Number Of AsianPacific Islander Beneficiaries | 60 |
| Number Of Hispanic Beneficiaries | 48 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 3201 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 686 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.562 |