| National Provider Identifier [NPI]: | 1982734208 |
| Last Name Of The Provider | ERICKSON |
| First Name Of The Provider | BRADLEY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 550 S LANDMARK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLOOMINGTON |
| Zip Code Of The Provider | 474033239 |
| State Code Of The Provider | IN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 99 |
| Number Of Services | 2622 |
| Number Of Medicare Beneficiaries | 573 |
| Total Submitted Charge Amount | 341523 |
| Total Medicare Allowed Amount | 192066.99 |
| Total Medicare Payment Amount | 149172.7 |
| Total Medicare Standardized Payment Amount | 157254.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 344 |
| Number Of Medicare Beneficiaries With Drug Services | 133 |
| Total Drug Submitted ChargeAmount | 2931 |
| Total Drug Medicare AllowedAmount | 2331.5 |
| Total Drug Medicare PaymentAmount | 2192.29 |
| Total Drug Medicare Standardized Payment Amount | 2192.29 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 2278 |
| Number Of Medicare Beneficiaries With Medical Services | 572 |
| Total Medical Submitted Charge Amount | 338592 |
| Total Medical Medicare Allowed Amount | 189735.49 |
| Total Medical Medicare Payment Amount | 146980.41 |
| Total Medical Medicare Standardized Payment Amount | 155062.62 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 110 |
| Number Of Beneficiaries Age 65 to 74 | 227 |
| Number Of Beneficiaries Age 75 to 84 | 174 |
| Number Of Beneficiaries Age Greater 84 | 62 |
| Number Of Female Beneficiaries | 284 |
| Number Of Male Beneficiaries | 289 |
| Number Of Non Hispanic White Beneficiaries | 562 |
| 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 | 426 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 147 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 34 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 64 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.5642 |