| National Provider Identifier [NPI]: | 1467652875 |
| Last Name Of The Provider | BRIMHALL |
| First Name Of The Provider | IAN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4830 HIGHWAY 260 |
| Street Address 2 Of The Provider | STE 103 |
| City Of The Provider | LAKESIDE |
| Zip Code Of The Provider | 859295845 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 135 |
| Number Of Services | 6952 |
| Number Of Medicare Beneficiaries | 451 |
| Total Submitted Charge Amount | 1435332 |
| Total Medicare Allowed Amount | 375623.44 |
| Total Medicare Payment Amount | 282107.67 |
| Total Medicare Standardized Payment Amount | 285164.06 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4392 |
| Number Of Medicare Beneficiaries With Drug Services | 204 |
| Total Drug Submitted ChargeAmount | 61808 |
| Total Drug Medicare AllowedAmount | 29242.03 |
| Total Drug Medicare PaymentAmount | 22773.66 |
| Total Drug Medicare Standardized Payment Amount | 22773.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 131 |
| Number Of Medical Services | 2560 |
| Number Of Medicare Beneficiaries With Medical Services | 451 |
| Total Medical Submitted Charge Amount | 1373524 |
| Total Medical Medicare Allowed Amount | 346381.41 |
| Total Medical Medicare Payment Amount | 259334.01 |
| Total Medical Medicare Standardized Payment Amount | 262390.4 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 246 |
| Number Of Beneficiaries Age 75 to 84 | 131 |
| Number Of Beneficiaries Age Greater 84 | 22 |
| Number Of Female Beneficiaries | 255 |
| Number Of Male Beneficiaries | 196 |
| Number Of Non Hispanic White Beneficiaries | 415 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 16 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 402 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0154 |