| National Provider Identifier [NPI]: | 1285643932 |
| Last Name Of The Provider | BRILL |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2801 W KINNICKINNIC RIVER PKWY |
| Street Address 2 Of The Provider | #250 |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 53215 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 542 |
| Number Of Medicare Beneficiaries | 190 |
| Total Submitted Charge Amount | 152774.68 |
| Total Medicare Allowed Amount | 50199.52 |
| Total Medicare Payment Amount | 36942.76 |
| Total Medicare Standardized Payment Amount | 38773.94 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 36 |
| Number Of Medicare Beneficiaries With Drug Services | 25 |
| Total Drug Submitted ChargeAmount | 1333.68 |
| Total Drug Medicare AllowedAmount | 769.85 |
| Total Drug Medicare PaymentAmount | 749.64 |
| Total Drug Medicare Standardized Payment Amount | 749.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 34 |
| Number Of Medical Services | 506 |
| Number Of Medicare Beneficiaries With Medical Services | 190 |
| Total Medical Submitted Charge Amount | 151441 |
| Total Medical Medicare Allowed Amount | 49429.67 |
| Total Medical Medicare Payment Amount | 36193.12 |
| Total Medical Medicare Standardized Payment Amount | 38024.3 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 70 |
| Number Of Beneficiaries Age 65 to 74 | 46 |
| Number Of Beneficiaries Age 75 to 84 | 45 |
| Number Of Beneficiaries Age Greater 84 | 29 |
| Number Of Female Beneficiaries | 102 |
| Number Of Male Beneficiaries | 88 |
| Number Of Non Hispanic White Beneficiaries | 115 |
| Number Of Black or African American Beneficiaries | 25 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 66 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 124 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 25 |
| Percent Of With Asthma | 20 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 54 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 16 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.0626 |