| National Provider Identifier [NPI]: | 1225011281 |
| Last Name Of The Provider | BRAVO |
| First Name Of The Provider | STEPHEN |
| 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 | 9350 TURKEY LAKE RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORLANDO |
| Zip Code Of The Provider | 328197319 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 150 |
| Number Of Services | 26740 |
| Number Of Medicare Beneficiaries | 2493 |
| Total Submitted Charge Amount | 4713445 |
| Total Medicare Allowed Amount | 834316.54 |
| Total Medicare Payment Amount | 636877.48 |
| Total Medicare Standardized Payment Amount | 675483.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 21766 |
| Number Of Medicare Beneficiaries With Drug Services | 555 |
| Total Drug Submitted ChargeAmount | 70347 |
| Total Drug Medicare AllowedAmount | 12637.55 |
| Total Drug Medicare PaymentAmount | 9788.79 |
| Total Drug Medicare Standardized Payment Amount | 9788.79 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 147 |
| Number Of Medical Services | 4974 |
| Number Of Medicare Beneficiaries With Medical Services | 2483 |
| Total Medical Submitted Charge Amount | 4643098 |
| Total Medical Medicare Allowed Amount | 821678.99 |
| Total Medical Medicare Payment Amount | 627088.69 |
| Total Medical Medicare Standardized Payment Amount | 665694.35 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 249 |
| Number Of Beneficiaries Age 65 to 74 | 1235 |
| Number Of Beneficiaries Age 75 to 84 | 754 |
| Number Of Beneficiaries Age Greater 84 | 255 |
| Number Of Female Beneficiaries | 1541 |
| Number Of Male Beneficiaries | 952 |
| Number Of Non Hispanic White Beneficiaries | 1956 |
| Number Of Black or African American Beneficiaries | 170 |
| Number Of AsianPacific Islander Beneficiaries | 66 |
| Number Of Hispanic Beneficiaries | 260 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2261 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 232 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 60 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1463 |