National Provider Identifier [NPI]: |
1003041641 |
Last Name Of The Provider |
KEEL |
First Name Of The Provider |
BRADLEY |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2525 DESALES AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
CHATTANOOGA |
Zip Code Of The Provider |
374041161 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
1813 |
Number Of Medicare Beneficiaries |
1618 |
Total Submitted Charge Amount |
1141888 |
Total Medicare Allowed Amount |
257999.23 |
Total Medicare Payment Amount |
190438.09 |
Total Medicare Standardized Payment Amount |
201649.83 |
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 |
31 |
Number Of Medical Services |
1813 |
Number Of Medicare Beneficiaries With Medical Services |
1618 |
Total Medical Submitted Charge Amount |
1141888 |
Total Medical Medicare Allowed Amount |
257999.23 |
Total Medical Medicare Payment Amount |
190438.09 |
Total Medical Medicare Standardized Payment Amount |
201649.83 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
327 |
Number Of Beneficiaries Age 65 to 74 |
464 |
Number Of Beneficiaries Age 75 to 84 |
500 |
Number Of Beneficiaries Age Greater 84 |
327 |
Number Of Female Beneficiaries |
945 |
Number Of Male Beneficiaries |
673 |
Number Of Non Hispanic White Beneficiaries |
1389 |
Number Of Black or African American Beneficiaries |
210 |
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 |
1193 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
425 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.9113 |