| National Provider Identifier [NPI]: | 1871557165 |
| Last Name Of The Provider | BRADFORD |
| First Name Of The Provider | ROBERT |
| 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 | 2000 CENTRE POINTE BLVD |
| Street Address 2 Of The Provider | SOUTHEASTERN UROLOGICAL CENTER PA |
| City Of The Provider | TALLAHASSEE |
| Zip Code Of The Provider | 32308 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 126 |
| Number Of Services | 7175 |
| Number Of Medicare Beneficiaries | 872 |
| Total Submitted Charge Amount | 934293.91 |
| Total Medicare Allowed Amount | 328503.29 |
| Total Medicare Payment Amount | 243670.9 |
| Total Medicare Standardized Payment Amount | 243535.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 16 |
| Number Of Drug Services | 4026 |
| Number Of Medicare Beneficiaries With Drug Services | 132 |
| Total Drug Submitted ChargeAmount | 258221.97 |
| Total Drug Medicare AllowedAmount | 103448.36 |
| Total Drug Medicare PaymentAmount | 80101.02 |
| Total Drug Medicare Standardized Payment Amount | 80101.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 110 |
| Number Of Medical Services | 3149 |
| Number Of Medicare Beneficiaries With Medical Services | 872 |
| Total Medical Submitted Charge Amount | 676071.94 |
| Total Medical Medicare Allowed Amount | 225054.93 |
| Total Medical Medicare Payment Amount | 163569.88 |
| Total Medical Medicare Standardized Payment Amount | 163434.93 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 336 |
| Number Of Beneficiaries Age 75 to 84 | 322 |
| Number Of Beneficiaries Age Greater 84 | 126 |
| Number Of Female Beneficiaries | 316 |
| Number Of Male Beneficiaries | 556 |
| Number Of Non Hispanic White Beneficiaries | 725 |
| Number Of Black or African American Beneficiaries | 119 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 711 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 161 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 25 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3006 |