| National Provider Identifier [NPI]: | 1114160389 |
| Last Name Of The Provider | BRADLEY |
| First Name Of The Provider | JESSE |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | D.P.M. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 S RHODES ST |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | WEST MEMPHIS |
| Zip Code Of The Provider | 723014212 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 2306 |
| Number Of Medicare Beneficiaries | 609 |
| Total Submitted Charge Amount | 204884.74 |
| Total Medicare Allowed Amount | 132112.04 |
| Total Medicare Payment Amount | 96837.88 |
| Total Medicare Standardized Payment Amount | 105876.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 35 |
| Number Of Medicare Beneficiaries With Drug Services | 19 |
| Total Drug Submitted ChargeAmount | 490 |
| Total Drug Medicare AllowedAmount | 57.47 |
| Total Drug Medicare PaymentAmount | 45.04 |
| Total Drug Medicare Standardized Payment Amount | 45.04 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 2271 |
| Number Of Medicare Beneficiaries With Medical Services | 609 |
| Total Medical Submitted Charge Amount | 204394.74 |
| Total Medical Medicare Allowed Amount | 132054.57 |
| Total Medical Medicare Payment Amount | 96792.84 |
| Total Medical Medicare Standardized Payment Amount | 105831.19 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 135 |
| Number Of Beneficiaries Age 65 to 74 | 160 |
| Number Of Beneficiaries Age 75 to 84 | 162 |
| Number Of Beneficiaries Age Greater 84 | 152 |
| Number Of Female Beneficiaries | 395 |
| Number Of Male Beneficiaries | 214 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | 344 |
| 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 | 135 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 474 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 52 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 58 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 23 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 2.0815 |