| National Provider Identifier [NPI]: | 1932254133 |
| Last Name Of The Provider | BAGLEY |
| First Name Of The Provider | BRETT |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | P.A. - CERTIFIED |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 556 TREJO ST |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | REXBURG |
| Zip Code Of The Provider | 834402625 |
| State Code Of The Provider | ID |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 1153 |
| Number Of Medicare Beneficiaries | 177 |
| Total Submitted Charge Amount | 104347 |
| Total Medicare Allowed Amount | 76330.89 |
| Total Medicare Payment Amount | 55413.62 |
| Total Medicare Standardized Payment Amount | 72946.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 43 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 430 |
| Total Drug Medicare AllowedAmount | 76.6 |
| Total Drug Medicare PaymentAmount | 59.95 |
| Total Drug Medicare Standardized Payment Amount | 59.95 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 1110 |
| Number Of Medicare Beneficiaries With Medical Services | 177 |
| Total Medical Submitted Charge Amount | 103917 |
| Total Medical Medicare Allowed Amount | 76254.29 |
| Total Medical Medicare Payment Amount | 55353.67 |
| Total Medical Medicare Standardized Payment Amount | 72886.08 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 93 |
| Number Of Beneficiaries Age 75 to 84 | 54 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 95 |
| Number Of Male Beneficiaries | 82 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 29 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 0 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6671 |