| National Provider Identifier [NPI]: | 1558562496 |
| Last Name Of The Provider | BRAY |
| First Name Of The Provider | MACEY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | MSC10 5530 |
| Street Address 2 Of The Provider | 1 UNIVERSITY OF NEW MEXICO |
| City Of The Provider | ALBUQUERQUE |
| Zip Code Of The Provider | 871310001 |
| State Code Of The Provider | NM |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 146 |
| Number Of Services | 5365 |
| Number Of Medicare Beneficiaries | 2340 |
| Total Submitted Charge Amount | 808644.44 |
| Total Medicare Allowed Amount | 167994.73 |
| Total Medicare Payment Amount | 128755.32 |
| Total Medicare Standardized Payment Amount | 132547.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 146 |
| Number Of Medical Services | 5365 |
| Number Of Medicare Beneficiaries With Medical Services | 2340 |
| Total Medical Submitted Charge Amount | 808644.44 |
| Total Medical Medicare Allowed Amount | 167994.73 |
| Total Medical Medicare Payment Amount | 128755.32 |
| Total Medical Medicare Standardized Payment Amount | 132547.07 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 481 |
| Number Of Beneficiaries Age 65 to 74 | 747 |
| Number Of Beneficiaries Age 75 to 84 | 702 |
| Number Of Beneficiaries Age Greater 84 | 410 |
| Number Of Female Beneficiaries | 1343 |
| Number Of Male Beneficiaries | 997 |
| Number Of Non Hispanic White Beneficiaries | 1342 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 278 |
| Number Of American Indian Alaska Native Beneficiaries | 690 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1468 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 872 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.0332 |