| National Provider Identifier [NPI]: | 1922034891 |
| Last Name Of The Provider | BRIDGE |
| First Name Of The Provider | STEPHEN |
| 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 | 4060 4TH AVE |
| Street Address 2 Of The Provider | SUITE 310 |
| City Of The Provider | SAN DIEGO |
| Zip Code Of The Provider | 921032116 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 4249 |
| Number Of Medicare Beneficiaries | 591 |
| Total Submitted Charge Amount | 790198.58 |
| Total Medicare Allowed Amount | 263297.21 |
| Total Medicare Payment Amount | 197077.95 |
| Total Medicare Standardized Payment Amount | 191932.24 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 1578 |
| Number Of Medicare Beneficiaries With Drug Services | 60 |
| Total Drug Submitted ChargeAmount | 212050 |
| Total Drug Medicare AllowedAmount | 48468.06 |
| Total Drug Medicare PaymentAmount | 37823.55 |
| Total Drug Medicare Standardized Payment Amount | 37823.55 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 2671 |
| Number Of Medicare Beneficiaries With Medical Services | 591 |
| Total Medical Submitted Charge Amount | 578148.58 |
| Total Medical Medicare Allowed Amount | 214829.15 |
| Total Medical Medicare Payment Amount | 159254.4 |
| Total Medical Medicare Standardized Payment Amount | 154108.69 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 37 |
| Number Of Beneficiaries Age 65 to 74 | 241 |
| Number Of Beneficiaries Age 75 to 84 | 209 |
| Number Of Beneficiaries Age Greater 84 | 104 |
| Number Of Female Beneficiaries | 141 |
| Number Of Male Beneficiaries | 450 |
| Number Of Non Hispanic White Beneficiaries | 482 |
| Number Of Black or African American Beneficiaries | 20 |
| Number Of AsianPacific Islander Beneficiaries | 27 |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 504 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2564 |