| National Provider Identifier [NPI]: | 1972577781 |
| Last Name Of The Provider | BRANTLEY |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3950 AUSTELL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | AUSTELL |
| Zip Code Of The Provider | 301061121 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 5449 |
| Number Of Medicare Beneficiaries | 3283 |
| Total Submitted Charge Amount | 558283 |
| Total Medicare Allowed Amount | 119718.58 |
| Total Medicare Payment Amount | 98155.71 |
| Total Medicare Standardized Payment Amount | 98748.62 |
| Drug Suppress Indicator | * |
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| Medical SuppressIndicator | # |
| Number Of HCPCS Associated With MedicalServices | |
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| Number Of Medicare Beneficiaries With Medical Services | |
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| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 531 |
| Number Of Beneficiaries Age 65 to 74 | 1394 |
| Number Of Beneficiaries Age 75 to 84 | 961 |
| Number Of Beneficiaries Age Greater 84 | 397 |
| Number Of Female Beneficiaries | 2348 |
| Number Of Male Beneficiaries | 935 |
| Number Of Non Hispanic White Beneficiaries | 2621 |
| Number Of Black or African American Beneficiaries | 520 |
| Number Of AsianPacific Islander Beneficiaries | 34 |
| Number Of Hispanic Beneficiaries | 76 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 2680 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 603 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.7305 |