| National Provider Identifier [NPI]: | 1962414235 |
| Last Name Of The Provider | MILLER |
| First Name Of The Provider | BRENT |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | NP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 212 S SULLIVAN |
| Street Address 2 Of The Provider | |
| City Of The Provider | FREMONT |
| Zip Code Of The Provider | 49412 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 347 |
| Number Of Medicare Beneficiaries | 306 |
| Total Submitted Charge Amount | 121408 |
| Total Medicare Allowed Amount | 31500.92 |
| Total Medicare Payment Amount | 23983.14 |
| Total Medicare Standardized Payment Amount | 28726.79 |
| 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 | 16 |
| Number Of Medical Services | 347 |
| Number Of Medicare Beneficiaries With Medical Services | 306 |
| Total Medical Submitted Charge Amount | 121408 |
| Total Medical Medicare Allowed Amount | 31500.92 |
| Total Medical Medicare Payment Amount | 23983.14 |
| Total Medical Medicare Standardized Payment Amount | 28726.79 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 147 |
| Number Of Beneficiaries Age 65 to 74 | 83 |
| Number Of Beneficiaries Age 75 to 84 | 48 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 181 |
| Number Of Male Beneficiaries | 125 |
| Number Of Non Hispanic White Beneficiaries | 283 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 139 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 167 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2625 |