National Provider Identifier [NPI]: |
1639182413 |
Last Name Of The Provider |
BRADBROOK |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
650 HOWE AVE |
Street Address 2 Of The Provider |
STE 830 |
City Of The Provider |
SACRAMENTO |
Zip Code Of The Provider |
958254731 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
291 |
Number Of Medicare Beneficiaries |
208 |
Total Submitted Charge Amount |
63085 |
Total Medicare Allowed Amount |
31652.63 |
Total Medicare Payment Amount |
21351.97 |
Total Medicare Standardized Payment Amount |
20286.44 |
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 |
12 |
Number Of Medical Services |
291 |
Number Of Medicare Beneficiaries With Medical Services |
208 |
Total Medical Submitted Charge Amount |
63085 |
Total Medical Medicare Allowed Amount |
31652.63 |
Total Medical Medicare Payment Amount |
21351.97 |
Total Medical Medicare Standardized Payment Amount |
20286.44 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
54 |
Number Of Beneficiaries Age 65 to 74 |
93 |
Number Of Beneficiaries Age 75 to 84 |
49 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
123 |
Number Of Male Beneficiaries |
85 |
Number Of Non Hispanic White Beneficiaries |
67 |
Number Of Black or African American Beneficiaries |
29 |
Number Of AsianPacific Islander Beneficiaries |
60 |
Number Of Hispanic Beneficiaries |
38 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
34 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
174 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
9 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
18 |
Percent Of With Diabetes |
65 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
23 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1221 |