National Provider Identifier [NPI]: |
1679506505 |
Last Name Of The Provider |
BRADLEY |
First Name Of The Provider |
BRENDAN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
CRNA |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
595 W STATE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
DOYLESTOWN |
Zip Code Of The Provider |
189012554 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
CRNA |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
45 |
Number Of Services |
273 |
Number Of Medicare Beneficiaries |
268 |
Total Submitted Charge Amount |
275059.2 |
Total Medicare Allowed Amount |
31822.33 |
Total Medicare Payment Amount |
24777.97 |
Total Medicare Standardized Payment Amount |
23409.94 |
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 |
45 |
Number Of Medical Services |
273 |
Number Of Medicare Beneficiaries With Medical Services |
268 |
Total Medical Submitted Charge Amount |
275059.2 |
Total Medical Medicare Allowed Amount |
31822.33 |
Total Medical Medicare Payment Amount |
24777.97 |
Total Medical Medicare Standardized Payment Amount |
23409.94 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
13 |
Number Of Beneficiaries Age 65 to 74 |
140 |
Number Of Beneficiaries Age 75 to 84 |
87 |
Number Of Beneficiaries Age Greater 84 |
28 |
Number Of Female Beneficiaries |
143 |
Number Of Male Beneficiaries |
125 |
Number Of Non Hispanic White Beneficiaries |
256 |
Number Of Black or African American Beneficiaries |
|
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 |
252 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
16 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.1925 |