| National Provider Identifier [NPI]: | 1679734354 |
| Last Name Of The Provider | BRADSHAW |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2925 RYAN DR SE |
| Street Address 2 Of The Provider | |
| City Of The Provider | SALEM |
| Zip Code Of The Provider | 973019687 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 3050 |
| Number Of Medicare Beneficiaries | 1730 |
| Total Submitted Charge Amount | 380578.64 |
| Total Medicare Allowed Amount | 129399.79 |
| Total Medicare Payment Amount | 103117.93 |
| Total Medicare Standardized Payment Amount | 108688.46 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 324 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 2137.64 |
| Total Drug Medicare AllowedAmount | 643.13 |
| Total Drug Medicare PaymentAmount | 467.89 |
| Total Drug Medicare Standardized Payment Amount | 467.89 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 169 |
| Number Of Medical Services | 2726 |
| Number Of Medicare Beneficiaries With Medical Services | 1730 |
| Total Medical Submitted Charge Amount | 378441 |
| Total Medical Medicare Allowed Amount | 128756.66 |
| Total Medical Medicare Payment Amount | 102650.04 |
| Total Medical Medicare Standardized Payment Amount | 108220.57 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 369 |
| Number Of Beneficiaries Age 65 to 74 | 732 |
| Number Of Beneficiaries Age 75 to 84 | 383 |
| Number Of Beneficiaries Age Greater 84 | 246 |
| Number Of Female Beneficiaries | 1154 |
| Number Of Male Beneficiaries | 576 |
| Number Of Non Hispanic White Beneficiaries | 1546 |
| Number Of Black or African American Beneficiaries | 14 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 94 |
| Number Of American Indian Alaska Native Beneficiaries | 31 |
| Number Of Beneficiaries With Race Not Else where Classified | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1270 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 460 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.4967 |