| National Provider Identifier [NPI]: | 1891895967 |
| Last Name Of The Provider | BRUNELLE |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 508 S HABANA AVE |
| Street Address 2 Of The Provider | SUITE 370 |
| City Of The Provider | TAMPA |
| Zip Code Of The Provider | 336094181 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 5744 |
| Number Of Medicare Beneficiaries | 429 |
| Total Submitted Charge Amount | 867649 |
| Total Medicare Allowed Amount | 437250.06 |
| Total Medicare Payment Amount | 327989.03 |
| Total Medicare Standardized Payment Amount | 331518.54 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 236 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 46530 |
| Total Drug Medicare AllowedAmount | 21055.76 |
| Total Drug Medicare PaymentAmount | 16476.82 |
| Total Drug Medicare Standardized Payment Amount | 16476.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 5508 |
| Number Of Medicare Beneficiaries With Medical Services | 429 |
| Total Medical Submitted Charge Amount | 821119 |
| Total Medical Medicare Allowed Amount | 416194.3 |
| Total Medical Medicare Payment Amount | 311512.21 |
| Total Medical Medicare Standardized Payment Amount | 315041.72 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 19 |
| Number Of Beneficiaries Age 65 to 74 | 187 |
| Number Of Beneficiaries Age 75 to 84 | 166 |
| Number Of Beneficiaries Age Greater 84 | 57 |
| Number Of Female Beneficiaries | 104 |
| Number Of Male Beneficiaries | 325 |
| Number Of Non Hispanic White Beneficiaries | 367 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 410 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 23 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1255 |