| National Provider Identifier [NPI]: | 1154536696 |
| Last Name Of The Provider | BRICKNER |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2019 S 6TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BRAINERD |
| Zip Code Of The Provider | 564014528 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 174 |
| Number Of Services | 3235 |
| Number Of Medicare Beneficiaries | 1954 |
| Total Submitted Charge Amount | 410035.86 |
| Total Medicare Allowed Amount | 106299.13 |
| Total Medicare Payment Amount | 80412.02 |
| Total Medicare Standardized Payment Amount | 82355.66 |
| 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 | 174 |
| Number Of Medical Services | 3235 |
| Number Of Medicare Beneficiaries With Medical Services | 1954 |
| Total Medical Submitted Charge Amount | 410035.86 |
| Total Medical Medicare Allowed Amount | 106299.13 |
| Total Medical Medicare Payment Amount | 80412.02 |
| Total Medical Medicare Standardized Payment Amount | 82355.66 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 487 |
| Number Of Beneficiaries Age 65 to 74 | 588 |
| Number Of Beneficiaries Age 75 to 84 | 579 |
| Number Of Beneficiaries Age Greater 84 | 300 |
| Number Of Female Beneficiaries | 1217 |
| Number Of Male Beneficiaries | 737 |
| Number Of Non Hispanic White Beneficiaries | 1877 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 43 |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1437 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 517 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2541 |