| National Provider Identifier [NPI]: | 1083641062 |
| Last Name Of The Provider | GRAHAM |
| First Name Of The Provider | BRADLEY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1367 DOMINION PLAZA |
| Street Address 2 Of The Provider | |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757031013 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 18500 |
| Number Of Medicare Beneficiaries | 5960 |
| Total Submitted Charge Amount | 2697592.17 |
| Total Medicare Allowed Amount | 1015815.38 |
| Total Medicare Payment Amount | 754770.67 |
| Total Medicare Standardized Payment Amount | 696247.89 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 455 |
| Number Of Medicare Beneficiaries With Drug Services | 68 |
| Total Drug Submitted ChargeAmount | 8718.97 |
| Total Drug Medicare AllowedAmount | 4505.23 |
| Total Drug Medicare PaymentAmount | 3460.64 |
| Total Drug Medicare Standardized Payment Amount | 3460.64 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 18045 |
| Number Of Medicare Beneficiaries With Medical Services | 5959 |
| Total Medical Submitted Charge Amount | 2688873.2 |
| Total Medical Medicare Allowed Amount | 1011310.15 |
| Total Medical Medicare Payment Amount | 751310.03 |
| Total Medical Medicare Standardized Payment Amount | 692787.25 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 267 |
| Number Of Beneficiaries Age 65 to 74 | 2496 |
| Number Of Beneficiaries Age 75 to 84 | 2337 |
| Number Of Beneficiaries Age Greater 84 | 860 |
| Number Of Female Beneficiaries | 2582 |
| Number Of Male Beneficiaries | 3378 |
| Number Of Non Hispanic White Beneficiaries | 5783 |
| Number Of Black or African American Beneficiaries | 83 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 5585 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 375 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0763 |