| National Provider Identifier [NPI]: | 1316990807 |
| Last Name Of The Provider | BRENNER-VINCENT |
| First Name Of The Provider | MICHELE |
| 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 | 2602 BUFORD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 232353422 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 134 |
| Number Of Services | 6360 |
| Number Of Medicare Beneficiaries | 3840 |
| Total Submitted Charge Amount | 523204.58 |
| Total Medicare Allowed Amount | 168336.74 |
| Total Medicare Payment Amount | 133599.8 |
| Total Medicare Standardized Payment Amount | 136743.6 |
| 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 | 134 |
| Number Of Medical Services | 6360 |
| Number Of Medicare Beneficiaries With Medical Services | 3840 |
| Total Medical Submitted Charge Amount | 523204.58 |
| Total Medical Medicare Allowed Amount | 168336.74 |
| Total Medical Medicare Payment Amount | 133599.8 |
| Total Medical Medicare Standardized Payment Amount | 136743.6 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 713 |
| Number Of Beneficiaries Age 65 to 74 | 1380 |
| Number Of Beneficiaries Age 75 to 84 | 1103 |
| Number Of Beneficiaries Age Greater 84 | 644 |
| Number Of Female Beneficiaries | 2665 |
| Number Of Male Beneficiaries | 1175 |
| Number Of Non Hispanic White Beneficiaries | 2173 |
| Number Of Black or African American Beneficiaries | 1570 |
| Number Of AsianPacific Islander Beneficiaries | 38 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2866 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 974 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7189 |