| National Provider Identifier [NPI]: | 1720067499 |
| Last Name Of The Provider | LEWIS |
| First Name Of The Provider | BRADLEY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 200 1ST ST SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCHESTER |
| Zip Code Of The Provider | 559050001 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 120 |
| Number Of Services | 6436 |
| Number Of Medicare Beneficiaries | 2826 |
| Total Submitted Charge Amount | 216070.58 |
| Total Medicare Allowed Amount | 162482.14 |
| Total Medicare Payment Amount | 119980.7 |
| Total Medicare Standardized Payment Amount | 130824.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 2260 |
| Number Of Medicare Beneficiaries With Drug Services | 16 |
| Total Drug Submitted ChargeAmount | 417.9 |
| Total Drug Medicare AllowedAmount | 405.82 |
| Total Drug Medicare PaymentAmount | 300.16 |
| Total Drug Medicare Standardized Payment Amount | 300.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 119 |
| Number Of Medical Services | 4176 |
| Number Of Medicare Beneficiaries With Medical Services | 2826 |
| Total Medical Submitted Charge Amount | 215652.68 |
| Total Medical Medicare Allowed Amount | 162076.32 |
| Total Medical Medicare Payment Amount | 119680.54 |
| Total Medical Medicare Standardized Payment Amount | 130524.66 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 538 |
| Number Of Beneficiaries Age 65 to 74 | 990 |
| Number Of Beneficiaries Age 75 to 84 | 852 |
| Number Of Beneficiaries Age Greater 84 | 446 |
| Number Of Female Beneficiaries | 1334 |
| Number Of Male Beneficiaries | 1492 |
| Number Of Non Hispanic White Beneficiaries | 2669 |
| Number Of Black or African American Beneficiaries | 47 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | 21 |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2317 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 509 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.916 |