| National Provider Identifier [NPI]: | 1053301879 |
| Last Name Of The Provider | EBEL |
| First Name Of The Provider | BRADLEY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 770 PINE ST STE 290 |
| Street Address 2 Of The Provider | ATTN: RADIOLOGY DEPARTMENT |
| City Of The Provider | MACON |
| Zip Code Of The Provider | 312017516 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 193 |
| Number Of Services | 6596 |
| Number Of Medicare Beneficiaries | 3838 |
| Total Submitted Charge Amount | 650439 |
| Total Medicare Allowed Amount | 159870.16 |
| Total Medicare Payment Amount | 120385.72 |
| Total Medicare Standardized Payment Amount | 127865.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 1127 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 4649 |
| Total Drug Medicare AllowedAmount | 367.47 |
| Total Drug Medicare PaymentAmount | 288.06 |
| Total Drug Medicare Standardized Payment Amount | 288.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 190 |
| Number Of Medical Services | 5469 |
| Number Of Medicare Beneficiaries With Medical Services | 3837 |
| Total Medical Submitted Charge Amount | 645790 |
| Total Medical Medicare Allowed Amount | 159502.69 |
| Total Medical Medicare Payment Amount | 120097.66 |
| Total Medical Medicare Standardized Payment Amount | 127577.93 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 863 |
| Number Of Beneficiaries Age 65 to 74 | 1488 |
| Number Of Beneficiaries Age 75 to 84 | 1051 |
| Number Of Beneficiaries Age Greater 84 | 436 |
| Number Of Female Beneficiaries | 2184 |
| Number Of Male Beneficiaries | 1654 |
| Number Of Non Hispanic White Beneficiaries | 2649 |
| Number Of Black or African American Beneficiaries | 1130 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2683 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1155 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9403 |