National Provider Identifier [NPI]: |
1467432658 |
Last Name Of The Provider |
BRYAN |
First Name Of The Provider |
BRADLEY |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
171 MOREY DR |
Street Address 2 Of The Provider |
SUITE B |
City Of The Provider |
MARYSVILLE |
Zip Code Of The Provider |
430401644 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
464 |
Number Of Medicare Beneficiaries |
250 |
Total Submitted Charge Amount |
262960 |
Total Medicare Allowed Amount |
87255.2 |
Total Medicare Payment Amount |
65817.37 |
Total Medicare Standardized Payment Amount |
68401.24 |
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 |
75 |
Number Of Medical Services |
464 |
Number Of Medicare Beneficiaries With Medical Services |
250 |
Total Medical Submitted Charge Amount |
262960 |
Total Medical Medicare Allowed Amount |
87255.2 |
Total Medical Medicare Payment Amount |
65817.37 |
Total Medical Medicare Standardized Payment Amount |
68401.24 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
31 |
Number Of Beneficiaries Age 65 to 74 |
127 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
134 |
Number Of Male Beneficiaries |
116 |
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 |
211 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2156 |