| National Provider Identifier [NPI]: | 1780861476 |
| Last Name Of The Provider | RYAN |
| First Name Of The Provider | BRENT |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD, MPH |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 800 E 28TH ST |
| Street Address 2 Of The Provider | MAIL ROUTE 11326 |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554073799 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 296 |
| Number Of Medicare Beneficiaries | 220 |
| Total Submitted Charge Amount | 147169 |
| Total Medicare Allowed Amount | 45900.55 |
| Total Medicare Payment Amount | 35595.4 |
| Total Medicare Standardized Payment Amount | 36549.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 296 |
| Number Of Medicare Beneficiaries With Medical Services | 220 |
| Total Medical Submitted Charge Amount | 147169 |
| Total Medical Medicare Allowed Amount | 45900.55 |
| Total Medical Medicare Payment Amount | 35595.4 |
| Total Medical Medicare Standardized Payment Amount | 36549.97 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 53 |
| Number Of Beneficiaries Age 75 to 84 | 75 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 107 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | 180 |
| Number Of Black or African American Beneficiaries | 25 |
| 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 | 152 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 68 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 56 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 43 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.3665 |