| National Provider Identifier [NPI]: | 1427202621 |
| Last Name Of The Provider | WELLS |
| First Name Of The Provider | BRADLEY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 911 BYPASS RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PIKEVILLE |
| Zip Code Of The Provider | 415011689 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 183 |
| Number Of Services | 8254 |
| Number Of Medicare Beneficiaries | 4210 |
| Total Submitted Charge Amount | 1975942.67 |
| Total Medicare Allowed Amount | 251328.54 |
| Total Medicare Payment Amount | 193637.07 |
| Total Medicare Standardized Payment Amount | 206833.26 |
| 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 | 183 |
| Number Of Medical Services | 8254 |
| Number Of Medicare Beneficiaries With Medical Services | 4210 |
| Total Medical Submitted Charge Amount | 1975942.67 |
| Total Medical Medicare Allowed Amount | 251328.54 |
| Total Medical Medicare Payment Amount | 193637.07 |
| Total Medical Medicare Standardized Payment Amount | 206833.26 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 1614 |
| Number Of Beneficiaries Age 65 to 74 | 1460 |
| Number Of Beneficiaries Age 75 to 84 | 844 |
| Number Of Beneficiaries Age Greater 84 | 292 |
| Number Of Female Beneficiaries | 2352 |
| Number Of Male Beneficiaries | 1858 |
| Number Of Non Hispanic White Beneficiaries | 4164 |
| Number Of Black or African American Beneficiaries | 13 |
| 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 | 18 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2484 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1726 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 39 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5999 |