| National Provider Identifier [NPI]: | 1407876188 |
| Last Name Of The Provider | BRICKLE |
| First Name Of The Provider | SUSAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 120 E CARTER AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLACKSHEAR |
| Zip Code Of The Provider | 315161561 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 123 |
| Number Of Services | 4018 |
| Number Of Medicare Beneficiaries | 657 |
| Total Submitted Charge Amount | 302285.04 |
| Total Medicare Allowed Amount | 185286.5 |
| Total Medicare Payment Amount | 132396.04 |
| Total Medicare Standardized Payment Amount | 139359.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 251 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 4000.04 |
| Total Drug Medicare AllowedAmount | 2527.06 |
| Total Drug Medicare PaymentAmount | 1995.99 |
| Total Drug Medicare Standardized Payment Amount | 1995.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 3767 |
| Number Of Medicare Beneficiaries With Medical Services | 657 |
| Total Medical Submitted Charge Amount | 298285 |
| Total Medical Medicare Allowed Amount | 182759.44 |
| Total Medical Medicare Payment Amount | 130400.05 |
| Total Medical Medicare Standardized Payment Amount | 137363.78 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 125 |
| Number Of Beneficiaries Age 65 to 74 | 255 |
| Number Of Beneficiaries Age 75 to 84 | 171 |
| Number Of Beneficiaries Age Greater 84 | 106 |
| Number Of Female Beneficiaries | 419 |
| Number Of Male Beneficiaries | 238 |
| Number Of Non Hispanic White Beneficiaries | 572 |
| Number Of Black or African American Beneficiaries | |
| 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 | 409 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 248 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5217 |