National Provider Identifier [NPI]: |
1215107693 |
Last Name Of The Provider |
BRESLOW |
First Name Of The Provider |
STEVEN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
111 W HIGH ST |
Street Address 2 Of The Provider |
SUITE 314 |
City Of The Provider |
ELKTON |
Zip Code Of The Provider |
219215529 |
State Code Of The Provider |
MD |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
1124 |
Number Of Medicare Beneficiaries |
293 |
Total Submitted Charge Amount |
103931 |
Total Medicare Allowed Amount |
89021.87 |
Total Medicare Payment Amount |
64961.53 |
Total Medicare Standardized Payment Amount |
64101.79 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
136 |
Number Of Medicare Beneficiaries With Drug Services |
108 |
Total Drug Submitted ChargeAmount |
5711 |
Total Drug Medicare AllowedAmount |
4334.16 |
Total Drug Medicare PaymentAmount |
4231.54 |
Total Drug Medicare Standardized Payment Amount |
4231.54 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
25 |
Number Of Medical Services |
988 |
Number Of Medicare Beneficiaries With Medical Services |
292 |
Total Medical Submitted Charge Amount |
98220 |
Total Medical Medicare Allowed Amount |
84687.71 |
Total Medical Medicare Payment Amount |
60729.99 |
Total Medical Medicare Standardized Payment Amount |
59870.25 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
66 |
Number Of Beneficiaries Age 65 to 74 |
130 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
165 |
Number Of Male Beneficiaries |
128 |
Number Of Non Hispanic White Beneficiaries |
259 |
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 |
234 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
59 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
28 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.2202 |