| National Provider Identifier [NPI]: | 1316926892 |
| Last Name Of The Provider | BRADLEY |
| First Name Of The Provider | ELIZABETH |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| 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 | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 68 |
| Number Of Services | 1648 |
| Number Of Medicare Beneficiaries | 264 |
| Total Submitted Charge Amount | 142529.24 |
| Total Medicare Allowed Amount | 114108.82 |
| Total Medicare Payment Amount | 85928.26 |
| Total Medicare Standardized Payment Amount | 83852.68 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1070 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 6451.4 |
| Total Drug Medicare AllowedAmount | 5608.88 |
| Total Drug Medicare PaymentAmount | 4166.86 |
| Total Drug Medicare Standardized Payment Amount | 4166.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 578 |
| Number Of Medicare Beneficiaries With Medical Services | 264 |
| Total Medical Submitted Charge Amount | 136077.84 |
| Total Medical Medicare Allowed Amount | 108499.94 |
| Total Medical Medicare Payment Amount | 81761.4 |
| Total Medical Medicare Standardized Payment Amount | 79685.82 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 107 |
| Number Of Beneficiaries Age 75 to 84 | 92 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 140 |
| Number Of Male Beneficiaries | 124 |
| Number Of Non Hispanic White Beneficiaries | 248 |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 234 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 30 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 53 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.1248 |