National Provider Identifier [NPI]: |
1083770903 |
Last Name Of The Provider |
BRADSHAW |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
77 E MERRIMACK ST |
Street Address 2 Of The Provider |
SUITE 15 |
City Of The Provider |
LOWELL |
Zip Code Of The Provider |
018521251 |
State Code Of The Provider |
MA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
1789 |
Number Of Medicare Beneficiaries |
558 |
Total Submitted Charge Amount |
360714 |
Total Medicare Allowed Amount |
184267.87 |
Total Medicare Payment Amount |
142714.63 |
Total Medicare Standardized Payment Amount |
132971.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
39 |
Number Of Medicare Beneficiaries With Drug Services |
38 |
Total Drug Submitted ChargeAmount |
1900 |
Total Drug Medicare AllowedAmount |
677.1 |
Total Drug Medicare PaymentAmount |
663.58 |
Total Drug Medicare Standardized Payment Amount |
663.58 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
37 |
Number Of Medical Services |
1750 |
Number Of Medicare Beneficiaries With Medical Services |
558 |
Total Medical Submitted Charge Amount |
358814 |
Total Medical Medicare Allowed Amount |
183590.77 |
Total Medical Medicare Payment Amount |
142051.05 |
Total Medical Medicare Standardized Payment Amount |
132307.43 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
196 |
Number Of Beneficiaries Age 75 to 84 |
149 |
Number Of Beneficiaries Age Greater 84 |
158 |
Number Of Female Beneficiaries |
330 |
Number Of Male Beneficiaries |
228 |
Number Of Non Hispanic White Beneficiaries |
526 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
12 |
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 |
355 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
203 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.7483 |