| National Provider Identifier [NPI]: | 1386746998 |
| Last Name Of The Provider | BRUCE |
| First Name Of The Provider | MARC |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 401 W POPLAR ST |
| Street Address 2 Of The Provider | RADIOLOGY |
| City Of The Provider | WALLA WALLA |
| Zip Code Of The Provider | 993622846 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 216 |
| Number Of Services | 4172 |
| Number Of Medicare Beneficiaries | 2342 |
| Total Submitted Charge Amount | 346234 |
| Total Medicare Allowed Amount | 143449.77 |
| Total Medicare Payment Amount | 112196.41 |
| Total Medicare Standardized Payment Amount | 115031.53 |
| 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 | 216 |
| Number Of Medical Services | 4172 |
| Number Of Medicare Beneficiaries With Medical Services | 2342 |
| Total Medical Submitted Charge Amount | 346234 |
| Total Medical Medicare Allowed Amount | 143449.77 |
| Total Medical Medicare Payment Amount | 112196.41 |
| Total Medical Medicare Standardized Payment Amount | 115031.53 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 303 |
| Number Of Beneficiaries Age 65 to 74 | 944 |
| Number Of Beneficiaries Age 75 to 84 | 643 |
| Number Of Beneficiaries Age Greater 84 | 452 |
| Number Of Female Beneficiaries | 1440 |
| Number Of Male Beneficiaries | 902 |
| Number Of Non Hispanic White Beneficiaries | 2173 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 109 |
| Number Of American Indian Alaska Native Beneficiaries | 18 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1901 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 441 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4097 |