| National Provider Identifier [NPI]: | 1063533412 |
| Last Name Of The Provider | POTSIC |
| First Name Of The Provider | BRADLEY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2020 PALOMINO LANE |
| Street Address 2 Of The Provider | STE # 100 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891064894 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 204 |
| Number Of Services | 23380 |
| Number Of Medicare Beneficiaries | 2785 |
| Total Submitted Charge Amount | 2093715.58 |
| Total Medicare Allowed Amount | 485663.17 |
| Total Medicare Payment Amount | 372332.14 |
| Total Medicare Standardized Payment Amount | 369910.71 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 19697 |
| Number Of Medicare Beneficiaries With Drug Services | 223 |
| Total Drug Submitted ChargeAmount | 56638.94 |
| Total Drug Medicare AllowedAmount | 5334.98 |
| Total Drug Medicare PaymentAmount | 4149.56 |
| Total Drug Medicare Standardized Payment Amount | 4149.56 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 196 |
| Number Of Medical Services | 3683 |
| Number Of Medicare Beneficiaries With Medical Services | 2783 |
| Total Medical Submitted Charge Amount | 2037076.64 |
| Total Medical Medicare Allowed Amount | 480328.19 |
| Total Medical Medicare Payment Amount | 368182.58 |
| Total Medical Medicare Standardized Payment Amount | 365761.15 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 495 |
| Number Of Beneficiaries Age 65 to 74 | 1236 |
| Number Of Beneficiaries Age 75 to 84 | 779 |
| Number Of Beneficiaries Age Greater 84 | 275 |
| Number Of Female Beneficiaries | 1631 |
| Number Of Male Beneficiaries | 1154 |
| Number Of Non Hispanic White Beneficiaries | 1975 |
| Number Of Black or African American Beneficiaries | 327 |
| Number Of AsianPacific Islander Beneficiaries | 129 |
| Number Of Hispanic Beneficiaries | 286 |
| Number Of American Indian Alaska Native Beneficiaries | 17 |
| Number Of Beneficiaries With Race Not Else where Classified | 51 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2150 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 635 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.738 |