| National Provider Identifier [NPI]: | 1366445991 |
| Last Name Of The Provider | TRAN |
| First Name Of The Provider | BRADLEY |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4085 UNIVERSITY BLVD S |
| Street Address 2 Of The Provider | SUITE 3 |
| City Of The Provider | JACKSONVILLE |
| Zip Code Of The Provider | 322164357 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 44 |
| Number Of Services | 1128 |
| Number Of Medicare Beneficiaries | 115 |
| Total Submitted Charge Amount | 115599.27 |
| Total Medicare Allowed Amount | 52623.07 |
| Total Medicare Payment Amount | 39366.58 |
| Total Medicare Standardized Payment Amount | 38374.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 441 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 6615 |
| Total Drug Medicare AllowedAmount | 566.58 |
| Total Drug Medicare PaymentAmount | 437.77 |
| Total Drug Medicare Standardized Payment Amount | 437.77 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 687 |
| Number Of Medicare Beneficiaries With Medical Services | 115 |
| Total Medical Submitted Charge Amount | 108984.27 |
| Total Medical Medicare Allowed Amount | 52056.49 |
| Total Medical Medicare Payment Amount | 38928.81 |
| Total Medical Medicare Standardized Payment Amount | 37936.32 |
| Average Age Of Beneficiaries | 62 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 29 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 72 |
| Number Of Male Beneficiaries | 43 |
| Number Of Non Hispanic White Beneficiaries | 73 |
| 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 | 62 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 53 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 33 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 13 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0338 |