National Provider Identifier [NPI]: |
1912965575 |
Last Name Of The Provider |
BRADWELL |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 TAYLOR RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
MONTGOMERY |
Zip Code Of The Provider |
361173512 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
902 |
Number Of Medicare Beneficiaries |
763 |
Total Submitted Charge Amount |
833393 |
Total Medicare Allowed Amount |
126079.82 |
Total Medicare Payment Amount |
96622.84 |
Total Medicare Standardized Payment Amount |
102047.21 |
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 |
38 |
Number Of Medical Services |
902 |
Number Of Medicare Beneficiaries With Medical Services |
763 |
Total Medical Submitted Charge Amount |
833393 |
Total Medical Medicare Allowed Amount |
126079.82 |
Total Medical Medicare Payment Amount |
96622.84 |
Total Medical Medicare Standardized Payment Amount |
102047.21 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
244 |
Number Of Beneficiaries Age 65 to 74 |
212 |
Number Of Beneficiaries Age 75 to 84 |
189 |
Number Of Beneficiaries Age Greater 84 |
118 |
Number Of Female Beneficiaries |
459 |
Number Of Male Beneficiaries |
304 |
Number Of Non Hispanic White Beneficiaries |
694 |
Number Of Black or African American Beneficiaries |
58 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
440 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
323 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
47 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.8137 |