| National Provider Identifier [NPI]: | 1366651192 |
| Last Name Of The Provider | BRINKMAN |
| First Name Of The Provider | MIKALA |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | BA, MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 530 NE GLEN OAK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | PEORIA |
| Zip Code Of The Provider | 616370001 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 161 |
| Number Of Services | 3404 |
| Number Of Medicare Beneficiaries | 2343 |
| Total Submitted Charge Amount | 601362 |
| Total Medicare Allowed Amount | 100625.29 |
| Total Medicare Payment Amount | 74152.18 |
| Total Medicare Standardized Payment Amount | 75332.77 |
| 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 | 161 |
| Number Of Medical Services | 3404 |
| Number Of Medicare Beneficiaries With Medical Services | 2343 |
| Total Medical Submitted Charge Amount | 601362 |
| Total Medical Medicare Allowed Amount | 100625.29 |
| Total Medical Medicare Payment Amount | 74152.18 |
| Total Medical Medicare Standardized Payment Amount | 75332.77 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 367 |
| Number Of Beneficiaries Age 65 to 74 | 944 |
| Number Of Beneficiaries Age 75 to 84 | 704 |
| Number Of Beneficiaries Age Greater 84 | 328 |
| Number Of Female Beneficiaries | 1364 |
| Number Of Male Beneficiaries | 979 |
| Number Of Non Hispanic White Beneficiaries | 2202 |
| Number Of Black or African American Beneficiaries | 78 |
| 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 | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1817 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 526 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 23 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3824 |