| National Provider Identifier [NPI]: | 1194862474 |
| Last Name Of The Provider | FERGUSON |
| First Name Of The Provider | BRADLEY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | N84W16889 MENOMONEE AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | MENOMONEE FALLS |
| Zip Code Of The Provider | 530512810 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 156 |
| Number Of Services | 11304 |
| Number Of Medicare Beneficiaries | 1769 |
| Total Submitted Charge Amount | 2202693 |
| Total Medicare Allowed Amount | 226418.26 |
| Total Medicare Payment Amount | 173381.45 |
| Total Medicare Standardized Payment Amount | 186112.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 8645 |
| Number Of Medicare Beneficiaries With Drug Services | 119 |
| Total Drug Submitted ChargeAmount | 21473 |
| Total Drug Medicare AllowedAmount | 2740.66 |
| Total Drug Medicare PaymentAmount | 1998.72 |
| Total Drug Medicare Standardized Payment Amount | 1998.72 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 150 |
| Number Of Medical Services | 2659 |
| Number Of Medicare Beneficiaries With Medical Services | 1769 |
| Total Medical Submitted Charge Amount | 2181220 |
| Total Medical Medicare Allowed Amount | 223677.6 |
| Total Medical Medicare Payment Amount | 171382.73 |
| Total Medical Medicare Standardized Payment Amount | 184114.04 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 235 |
| Number Of Beneficiaries Age 65 to 74 | 755 |
| Number Of Beneficiaries Age 75 to 84 | 545 |
| Number Of Beneficiaries Age Greater 84 | 234 |
| Number Of Female Beneficiaries | 1225 |
| Number Of Male Beneficiaries | 544 |
| Number Of Non Hispanic White Beneficiaries | 1548 |
| Number Of Black or African American Beneficiaries | 140 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 34 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1524 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 245 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2016 |