| National Provider Identifier [NPI]: | 1205134350 |
| Last Name Of The Provider | BRANDSTETTER |
| First Name Of The Provider | KIMBERLY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5620 W THUNDERBIRD RD |
| Street Address 2 Of The Provider | SUITE F-1 |
| City Of The Provider | GLENDALE |
| Zip Code Of The Provider | 853064636 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 2503 |
| Number Of Medicare Beneficiaries | 344 |
| Total Submitted Charge Amount | 213990 |
| Total Medicare Allowed Amount | 83654.74 |
| Total Medicare Payment Amount | 64043.98 |
| Total Medicare Standardized Payment Amount | 65452.56 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 57 |
| Number Of Medicare Beneficiaries With Drug Services | 42 |
| Total Drug Submitted ChargeAmount | 3280 |
| Total Drug Medicare AllowedAmount | 1716.26 |
| Total Drug Medicare PaymentAmount | 1660.38 |
| Total Drug Medicare Standardized Payment Amount | 1660.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 71 |
| Number Of Medical Services | 2446 |
| Number Of Medicare Beneficiaries With Medical Services | 344 |
| Total Medical Submitted Charge Amount | 210710 |
| Total Medical Medicare Allowed Amount | 81938.48 |
| Total Medical Medicare Payment Amount | 62383.6 |
| Total Medical Medicare Standardized Payment Amount | 63792.18 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 173 |
| Number Of Beneficiaries Age 75 to 84 | 96 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 237 |
| Number Of Male Beneficiaries | 107 |
| Number Of Non Hispanic White Beneficiaries | 309 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 17 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 322 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 22 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.076 |