| National Provider Identifier [NPI]: | 1568639185 |
| Last Name Of The Provider | BRUNE |
| First Name Of The Provider | BRIAN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2120 LAKELAND HILLS BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAKELAND |
| Zip Code Of The Provider | 338052906 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 176 |
| Number Of Services | 4837 |
| Number Of Medicare Beneficiaries | 1956 |
| Total Submitted Charge Amount | 658835.66 |
| Total Medicare Allowed Amount | 122680.66 |
| Total Medicare Payment Amount | 94971.32 |
| Total Medicare Standardized Payment Amount | 93669.11 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1480 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 1850 |
| Total Drug Medicare AllowedAmount | 329.16 |
| Total Drug Medicare PaymentAmount | 239.48 |
| Total Drug Medicare Standardized Payment Amount | 239.48 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 175 |
| Number Of Medical Services | 3357 |
| Number Of Medicare Beneficiaries With Medical Services | 1956 |
| Total Medical Submitted Charge Amount | 656985.66 |
| Total Medical Medicare Allowed Amount | 122351.5 |
| Total Medical Medicare Payment Amount | 94731.84 |
| Total Medical Medicare Standardized Payment Amount | 93429.63 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 347 |
| Number Of Beneficiaries Age 65 to 74 | 649 |
| Number Of Beneficiaries Age 75 to 84 | 560 |
| Number Of Beneficiaries Age Greater 84 | 400 |
| Number Of Female Beneficiaries | 1105 |
| Number Of Male Beneficiaries | 851 |
| Number Of Non Hispanic White Beneficiaries | 1381 |
| Number Of Black or African American Beneficiaries | 489 |
| Number Of AsianPacific Islander Beneficiaries | 37 |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1466 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 490 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 38 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.021 |