| National Provider Identifier [NPI]: | 1255308003 |
| Last Name Of The Provider | BRUAL |
| First Name Of The Provider | GERARDO |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 288 N IRONWOOD |
| Street Address 2 Of The Provider | #105 |
| City Of The Provider | APACHE JUNCTION |
| Zip Code Of The Provider | 852203830 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 90 |
| Number Of Services | 10620 |
| Number Of Medicare Beneficiaries | 1251 |
| Total Submitted Charge Amount | 2038037 |
| Total Medicare Allowed Amount | 1068261.36 |
| Total Medicare Payment Amount | 803316.91 |
| Total Medicare Standardized Payment Amount | 797997.67 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 112 |
| Number Of Medicare Beneficiaries With Drug Services | 23 |
| Total Drug Submitted ChargeAmount | 3100 |
| Total Drug Medicare AllowedAmount | 102.86 |
| Total Drug Medicare PaymentAmount | 76.33 |
| Total Drug Medicare Standardized Payment Amount | 76.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 87 |
| Number Of Medical Services | 10508 |
| Number Of Medicare Beneficiaries With Medical Services | 1251 |
| Total Medical Submitted Charge Amount | 2034937 |
| Total Medical Medicare Allowed Amount | 1068158.5 |
| Total Medical Medicare Payment Amount | 803240.58 |
| Total Medical Medicare Standardized Payment Amount | 797921.34 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 512 |
| Number Of Beneficiaries Age 75 to 84 | 511 |
| Number Of Beneficiaries Age Greater 84 | 185 |
| Number Of Female Beneficiaries | 587 |
| Number Of Male Beneficiaries | 664 |
| Number Of Non Hispanic White Beneficiaries | 1186 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 35 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1176 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 75 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0222 |