| National Provider Identifier [NPI]: | 1073525788 |
| Last Name Of The Provider | BREMMER |
| First Name Of The Provider | DEBORAH |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | P.A.C. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | N84W16889 MENOMONEE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MENOMONEE FALLS |
| Zip Code Of The Provider | 530512810 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 640 |
| Number Of Medicare Beneficiaries | 137 |
| Total Submitted Charge Amount | 930155.8 |
| Total Medicare Allowed Amount | 30292.94 |
| Total Medicare Payment Amount | 23358.21 |
| Total Medicare Standardized Payment Amount | 25488.47 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 350 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 24179 |
| Total Drug Medicare AllowedAmount | 10410.56 |
| Total Drug Medicare PaymentAmount | 8084.94 |
| Total Drug Medicare Standardized Payment Amount | 8084.94 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 35 |
| Number Of Medical Services | 290 |
| Number Of Medicare Beneficiaries With Medical Services | 137 |
| Total Medical Submitted Charge Amount | 905976.8 |
| Total Medical Medicare Allowed Amount | 19882.38 |
| Total Medical Medicare Payment Amount | 15273.27 |
| Total Medical Medicare Standardized Payment Amount | 17403.53 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 64 |
| Number Of Beneficiaries Age 75 to 84 | 41 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 96 |
| Number Of Male Beneficiaries | 41 |
| Number Of Non Hispanic White Beneficiaries | 123 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 124 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 13 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 16 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 16 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.941 |