| National Provider Identifier [NPI]: | 1699883785 |
| Last Name Of The Provider | BREAZEALE |
| First Name Of The Provider | BRETTON |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2900 DAGGETT AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | KLAMATH FALLS |
| Zip Code Of The Provider | 97601 |
| State Code Of The Provider | OR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 234 |
| Number Of Services | 5475 |
| Number Of Medicare Beneficiaries | 2913 |
| Total Submitted Charge Amount | 371905.15 |
| Total Medicare Allowed Amount | 180665.03 |
| Total Medicare Payment Amount | 138353.92 |
| Total Medicare Standardized Payment Amount | 141964.44 |
| 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 | 234 |
| Number Of Medical Services | 5475 |
| Number Of Medicare Beneficiaries With Medical Services | 2913 |
| Total Medical Submitted Charge Amount | 371905.15 |
| Total Medical Medicare Allowed Amount | 180665.03 |
| Total Medical Medicare Payment Amount | 138353.92 |
| Total Medical Medicare Standardized Payment Amount | 141964.44 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 483 |
| Number Of Beneficiaries Age 65 to 74 | 1196 |
| Number Of Beneficiaries Age 75 to 84 | 824 |
| Number Of Beneficiaries Age Greater 84 | 410 |
| Number Of Female Beneficiaries | 1749 |
| Number Of Male Beneficiaries | 1164 |
| Number Of Non Hispanic White Beneficiaries | 2667 |
| Number Of Black or African American Beneficiaries | 16 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 114 |
| Number Of American Indian Alaska Native Beneficiaries | 76 |
| Number Of Beneficiaries With Race Not Else where Classified | 28 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2335 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 578 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2478 |