National Provider Identifier [NPI]: |
1902044985 |
Last Name Of The Provider |
BRADEN |
First Name Of The Provider |
BEAU |
Middle Initial Of The Provider |
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Credentials Of The Provider |
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Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5050 AVE MARIA BLVD |
Street Address 2 Of The Provider |
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City Of The Provider |
AVE MARIA |
Zip Code Of The Provider |
341429505 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
1409 |
Number Of Medicare Beneficiaries |
826 |
Total Submitted Charge Amount |
1206275.84 |
Total Medicare Allowed Amount |
167705.54 |
Total Medicare Payment Amount |
131155.06 |
Total Medicare Standardized Payment Amount |
123554.6 |
Drug Suppress Indicator |
* |
Number Of HCPCS Associated With Drug Services |
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Number Of Drug Services |
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Number Of Medicare Beneficiaries With Drug Services |
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Total Drug Submitted ChargeAmount |
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Total Drug Medicare AllowedAmount |
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Total Drug Medicare PaymentAmount |
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Total Drug Medicare Standardized Payment Amount |
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Medical SuppressIndicator |
# |
Number Of HCPCS Associated With MedicalServices |
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Number Of Medical Services |
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Number Of Medicare Beneficiaries With Medical Services |
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Total Medical Submitted Charge Amount |
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Total Medical Medicare Allowed Amount |
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Total Medical Medicare Payment Amount |
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Total Medical Medicare Standardized Payment Amount |
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Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
88 |
Number Of Beneficiaries Age 65 to 74 |
246 |
Number Of Beneficiaries Age 75 to 84 |
266 |
Number Of Beneficiaries Age Greater 84 |
226 |
Number Of Female Beneficiaries |
441 |
Number Of Male Beneficiaries |
385 |
Number Of Non Hispanic White Beneficiaries |
733 |
Number Of Black or African American Beneficiaries |
27 |
Number Of AsianPacific Islander Beneficiaries |
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Number Of Hispanic Beneficiaries |
48 |
Number Of American Indian Alaska Native Beneficiaries |
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Number Of Beneficiaries With Race Not Else where Classified |
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Number Of Beneficiaries With Medicare Only Entitlement |
699 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
127 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
20 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
70 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
59 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.7722 |