| National Provider Identifier [NPI]: | 1427092212 |
| Last Name Of The Provider | DURELL |
| First Name Of The Provider | BRUCE |
| 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 | 201 PENNSYLVANIA PKWY |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | INDIANAPOLIS |
| Zip Code Of The Provider | 462802301 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 3208 |
| Number Of Medicare Beneficiaries | 571 |
| Total Submitted Charge Amount | 348579.5 |
| Total Medicare Allowed Amount | 170666.93 |
| Total Medicare Payment Amount | 128861.77 |
| Total Medicare Standardized Payment Amount | 136078.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 491 |
| Number Of Medicare Beneficiaries With Drug Services | 99 |
| Total Drug Submitted ChargeAmount | 17549.5 |
| Total Drug Medicare AllowedAmount | 7235.64 |
| Total Drug Medicare PaymentAmount | 5654.6 |
| Total Drug Medicare Standardized Payment Amount | 5654.6 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 2717 |
| Number Of Medicare Beneficiaries With Medical Services | 571 |
| Total Medical Submitted Charge Amount | 331030 |
| Total Medical Medicare Allowed Amount | 163431.29 |
| Total Medical Medicare Payment Amount | 123207.17 |
| Total Medical Medicare Standardized Payment Amount | 130424.36 |
| Average Age Of Beneficiaries | 59 |
| Number Of Beneficiaries Age Less65 | 350 |
| Number Of Beneficiaries Age 65 to 74 | 155 |
| Number Of Beneficiaries Age 75 to 84 | 54 |
| Number Of Beneficiaries Age Greater 84 | 12 |
| Number Of Female Beneficiaries | 368 |
| Number Of Male Beneficiaries | 203 |
| Number Of Non Hispanic White Beneficiaries | 500 |
| Number Of Black or African American Beneficiaries | 55 |
| 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 | 355 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 216 |
| Percent Of With Atrial Fibrillation | 4 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 5 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 64 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 58 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 74 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.4232 |