| National Provider Identifier [NPI]: | 1275712580 |
| Last Name Of The Provider | SULLIVAN |
| First Name Of The Provider | BRENDA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 955 YONKERS AVE |
| Street Address 2 Of The Provider | SUITE 110 |
| City Of The Provider | YONKERS |
| Zip Code Of The Provider | 107043060 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 73 |
| Number Of Services | 3553 |
| Number Of Medicare Beneficiaries | 263 |
| Total Submitted Charge Amount | 343203.5 |
| Total Medicare Allowed Amount | 137113.91 |
| Total Medicare Payment Amount | 109448.36 |
| Total Medicare Standardized Payment Amount | 99207.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 184 |
| Number Of Medicare Beneficiaries With Drug Services | 143 |
| Total Drug Submitted ChargeAmount | 6773.5 |
| Total Drug Medicare AllowedAmount | 3923.63 |
| Total Drug Medicare PaymentAmount | 3834.63 |
| Total Drug Medicare Standardized Payment Amount | 3834.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 3369 |
| Number Of Medicare Beneficiaries With Medical Services | 263 |
| Total Medical Submitted Charge Amount | 336430 |
| Total Medical Medicare Allowed Amount | 133190.28 |
| Total Medical Medicare Payment Amount | 105613.73 |
| Total Medical Medicare Standardized Payment Amount | 95373.28 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 15 |
| Number Of Beneficiaries Age 65 to 74 | 115 |
| Number Of Beneficiaries Age 75 to 84 | 90 |
| Number Of Beneficiaries Age Greater 84 | 43 |
| Number Of Female Beneficiaries | 205 |
| Number Of Male Beneficiaries | 58 |
| Number Of Non Hispanic White Beneficiaries | 227 |
| Number Of Black or African American Beneficiaries | |
| 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 | 228 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 35 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0631 |