| National Provider Identifier [NPI]: | 1033102124 |
| Last Name Of The Provider | BLACKBURN |
| First Name Of The Provider | BRADLEY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 103 PARTRIDGE LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHAGRIN FALLS |
| Zip Code Of The Provider | 440224010 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 109 |
| Number Of Services | 4394 |
| Number Of Medicare Beneficiaries | 3177 |
| Total Submitted Charge Amount | 403549 |
| Total Medicare Allowed Amount | 187556.18 |
| Total Medicare Payment Amount | 142467.08 |
| Total Medicare Standardized Payment Amount | 145285.57 |
| 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 | 109 |
| Number Of Medical Services | 4394 |
| Number Of Medicare Beneficiaries With Medical Services | 3177 |
| Total Medical Submitted Charge Amount | 403549 |
| Total Medical Medicare Allowed Amount | 187556.18 |
| Total Medical Medicare Payment Amount | 142467.08 |
| Total Medical Medicare Standardized Payment Amount | 145285.57 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 719 |
| Number Of Beneficiaries Age 65 to 74 | 916 |
| Number Of Beneficiaries Age 75 to 84 | 826 |
| Number Of Beneficiaries Age Greater 84 | 716 |
| Number Of Female Beneficiaries | 2115 |
| Number Of Male Beneficiaries | 1062 |
| Number Of Non Hispanic White Beneficiaries | 2488 |
| Number Of Black or African American Beneficiaries | 561 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 71 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 31 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1666 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1511 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 33 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 44 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 67 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0752 |