| National Provider Identifier [NPI]: | 1679695761 |
| Last Name Of The Provider | BLEAZARD |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 914 PINE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | MT SHASTA |
| Zip Code Of The Provider | 96067 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 176 |
| Number Of Services | 7502 |
| Number Of Medicare Beneficiaries | 2096 |
| Total Submitted Charge Amount | 962056.02 |
| Total Medicare Allowed Amount | 194449.33 |
| Total Medicare Payment Amount | 142385.02 |
| Total Medicare Standardized Payment Amount | 139405.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 3386 |
| Number Of Medicare Beneficiaries With Drug Services | 52 |
| Total Drug Submitted ChargeAmount | 6088 |
| Total Drug Medicare AllowedAmount | 1295.47 |
| Total Drug Medicare PaymentAmount | 987.37 |
| Total Drug Medicare Standardized Payment Amount | 987.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 174 |
| Number Of Medical Services | 4116 |
| Number Of Medicare Beneficiaries With Medical Services | 2096 |
| Total Medical Submitted Charge Amount | 955968.02 |
| Total Medical Medicare Allowed Amount | 193153.86 |
| Total Medical Medicare Payment Amount | 141397.65 |
| Total Medical Medicare Standardized Payment Amount | 138417.94 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 396 |
| Number Of Beneficiaries Age 65 to 74 | 953 |
| Number Of Beneficiaries Age 75 to 84 | 519 |
| Number Of Beneficiaries Age Greater 84 | 228 |
| Number Of Female Beneficiaries | 1253 |
| Number Of Male Beneficiaries | 843 |
| Number Of Non Hispanic White Beneficiaries | 1889 |
| Number Of Black or African American Beneficiaries | 46 |
| Number Of AsianPacific Islander Beneficiaries | 15 |
| Number Of Hispanic Beneficiaries | 93 |
| Number Of American Indian Alaska Native Beneficiaries | 25 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1532 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 564 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 42 |
| Percent Of With Hypertension | 56 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0303 |