| National Provider Identifier [NPI]: | 1295948206 |
| Last Name Of The Provider | KING |
| First Name Of The Provider | BRADLEY |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12368 STRATFORD DR |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | CLIVE |
| Zip Code Of The Provider | 503258162 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 164 |
| Number Of Services | 17742 |
| Number Of Medicare Beneficiaries | 4361 |
| Total Submitted Charge Amount | 710853 |
| Total Medicare Allowed Amount | 261162.96 |
| Total Medicare Payment Amount | 199265.17 |
| Total Medicare Standardized Payment Amount | 216803.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 10870 |
| Number Of Medicare Beneficiaries With Drug Services | 135 |
| Total Drug Submitted ChargeAmount | 8007.5 |
| Total Drug Medicare AllowedAmount | 3704.73 |
| Total Drug Medicare PaymentAmount | 2809.41 |
| Total Drug Medicare Standardized Payment Amount | 2809.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 160 |
| Number Of Medical Services | 6872 |
| Number Of Medicare Beneficiaries With Medical Services | 4361 |
| Total Medical Submitted Charge Amount | 702845.5 |
| Total Medical Medicare Allowed Amount | 257458.23 |
| Total Medical Medicare Payment Amount | 196455.76 |
| Total Medical Medicare Standardized Payment Amount | 213993.77 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 676 |
| Number Of Beneficiaries Age 65 to 74 | 1478 |
| Number Of Beneficiaries Age 75 to 84 | 1295 |
| Number Of Beneficiaries Age Greater 84 | 912 |
| Number Of Female Beneficiaries | 2573 |
| Number Of Male Beneficiaries | 1788 |
| Number Of Non Hispanic White Beneficiaries | 4097 |
| Number Of Black or African American Beneficiaries | 117 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 57 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 46 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3409 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 952 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5956 |