National Provider Identifier [NPI]: |
1902885007 |
Last Name Of The Provider |
EGBERT |
First Name Of The Provider |
BRADLEY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3535 SOUTHERN BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
KETTERING |
Zip Code Of The Provider |
454291221 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
77 |
Number Of Services |
449 |
Number Of Medicare Beneficiaries |
387 |
Total Submitted Charge Amount |
611299.2 |
Total Medicare Allowed Amount |
60381.49 |
Total Medicare Payment Amount |
47267.28 |
Total Medicare Standardized Payment Amount |
47463.65 |
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 |
77 |
Number Of Medical Services |
449 |
Number Of Medicare Beneficiaries With Medical Services |
387 |
Total Medical Submitted Charge Amount |
611299.2 |
Total Medical Medicare Allowed Amount |
60381.49 |
Total Medical Medicare Payment Amount |
47267.28 |
Total Medical Medicare Standardized Payment Amount |
47463.65 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
147 |
Number Of Beneficiaries Age 75 to 84 |
127 |
Number Of Beneficiaries Age Greater 84 |
49 |
Number Of Female Beneficiaries |
216 |
Number Of Male Beneficiaries |
171 |
Number Of Non Hispanic White Beneficiaries |
335 |
Number Of Black or African American Beneficiaries |
40 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
306 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
81 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
60 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9186 |