| National Provider Identifier [NPI]: | 1417045592 |
| Last Name Of The Provider | MILLER |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6021 FAIRMONT PKWY |
| Street Address 2 Of The Provider | STE 130 |
| City Of The Provider | PASADENA |
| Zip Code Of The Provider | 775054022 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 548 |
| Number Of Medicare Beneficiaries | 159 |
| Total Submitted Charge Amount | 82569 |
| Total Medicare Allowed Amount | 37256.06 |
| Total Medicare Payment Amount | 27286.32 |
| Total Medicare Standardized Payment Amount | 29205.03 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 20 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 450 |
| Total Drug Medicare AllowedAmount | 58.1 |
| Total Drug Medicare PaymentAmount | 42.83 |
| Total Drug Medicare Standardized Payment Amount | 42.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 528 |
| Number Of Medicare Beneficiaries With Medical Services | 159 |
| Total Medical Submitted Charge Amount | 82119 |
| Total Medical Medicare Allowed Amount | 37197.96 |
| Total Medical Medicare Payment Amount | 27243.49 |
| Total Medical Medicare Standardized Payment Amount | 29162.2 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 71 |
| Number Of Beneficiaries Age 75 to 84 | 43 |
| Number Of Beneficiaries Age Greater 84 | 15 |
| Number Of Female Beneficiaries | 92 |
| Number Of Male Beneficiaries | 67 |
| Number Of Non Hispanic White Beneficiaries | 105 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 27 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 123 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 36 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2912 |