National Provider Identifier [NPI]: |
1699793232 |
Last Name Of The Provider |
BRADLEY |
First Name Of The Provider |
JEFFREY |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4921 PARKVIEW PL |
Street Address 2 Of The Provider |
SITEMAN CANCER CENTER LOWER LEVEL |
City Of The Provider |
SAINT LOUIS |
Zip Code Of The Provider |
631101032 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Radiation Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
2894 |
Number Of Medicare Beneficiaries |
336 |
Total Submitted Charge Amount |
853223 |
Total Medicare Allowed Amount |
230565.81 |
Total Medicare Payment Amount |
179649.41 |
Total Medicare Standardized Payment Amount |
174369.62 |
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 |
37 |
Number Of Medical Services |
2894 |
Number Of Medicare Beneficiaries With Medical Services |
336 |
Total Medical Submitted Charge Amount |
853223 |
Total Medical Medicare Allowed Amount |
230565.81 |
Total Medical Medicare Payment Amount |
179649.41 |
Total Medical Medicare Standardized Payment Amount |
174369.62 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
43 |
Number Of Beneficiaries Age 65 to 74 |
146 |
Number Of Beneficiaries Age 75 to 84 |
109 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
151 |
Number Of Male Beneficiaries |
185 |
Number Of Non Hispanic White Beneficiaries |
291 |
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 |
275 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
61 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
75 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
54 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
56 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.9977 |