National Provider Identifier [NPI]: |
1841389053 |
Last Name Of The Provider |
BRADLEY |
First Name Of The Provider |
BETTY |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
210 E MAIN ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
CANDOR |
Zip Code Of The Provider |
272298088 |
State Code Of The Provider |
NC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
53 |
Number Of Services |
1145 |
Number Of Medicare Beneficiaries |
172 |
Total Submitted Charge Amount |
79759 |
Total Medicare Allowed Amount |
55942.46 |
Total Medicare Payment Amount |
40633.94 |
Total Medicare Standardized Payment Amount |
44154.9 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
142 |
Number Of Medicare Beneficiaries With Drug Services |
87 |
Total Drug Submitted ChargeAmount |
3181 |
Total Drug Medicare AllowedAmount |
2088.95 |
Total Drug Medicare PaymentAmount |
1938.98 |
Total Drug Medicare Standardized Payment Amount |
1938.98 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
44 |
Number Of Medical Services |
1003 |
Number Of Medicare Beneficiaries With Medical Services |
172 |
Total Medical Submitted Charge Amount |
76578 |
Total Medical Medicare Allowed Amount |
53853.51 |
Total Medical Medicare Payment Amount |
38694.96 |
Total Medical Medicare Standardized Payment Amount |
42215.92 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
62 |
Number Of Beneficiaries Age 65 to 74 |
63 |
Number Of Beneficiaries Age 75 to 84 |
26 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
79 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
113 |
Number Of Black or African American Beneficiaries |
45 |
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 |
99 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
73 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
27 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.029 |