| National Provider Identifier [NPI]: | 1891748034 |
| Last Name Of The Provider | ELICKER |
| First Name Of The Provider | BRETT |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1001 POTRERO AVE |
| Street Address 2 Of The Provider | RM 1X55 |
| City Of The Provider | SAN FRANCISCO |
| Zip Code Of The Provider | 941103518 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 2935 |
| Number Of Medicare Beneficiaries | 1676 |
| Total Submitted Charge Amount | 1064664 |
| Total Medicare Allowed Amount | 74269.28 |
| Total Medicare Payment Amount | 56458.98 |
| Total Medicare Standardized Payment Amount | 51321.27 |
| 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 | 42 |
| Number Of Medical Services | 2935 |
| Number Of Medicare Beneficiaries With Medical Services | 1676 |
| Total Medical Submitted Charge Amount | 1064664 |
| Total Medical Medicare Allowed Amount | 74269.28 |
| Total Medical Medicare Payment Amount | 56458.98 |
| Total Medical Medicare Standardized Payment Amount | 51321.27 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 420 |
| Number Of Beneficiaries Age 65 to 74 | 676 |
| Number Of Beneficiaries Age 75 to 84 | 415 |
| Number Of Beneficiaries Age Greater 84 | 165 |
| Number Of Female Beneficiaries | 787 |
| Number Of Male Beneficiaries | 889 |
| Number Of Non Hispanic White Beneficiaries | 1034 |
| Number Of Black or African American Beneficiaries | 126 |
| Number Of AsianPacific Islander Beneficiaries | 271 |
| Number Of Hispanic Beneficiaries | 192 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 956 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 720 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.4505 |