| National Provider Identifier [NPI]: | 1063400687 |
| Last Name Of The Provider | BRECKENRIDGE |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1244 FORT WASHINGTON AVE |
| Street Address 2 Of The Provider | SUITE I |
| City Of The Provider | FORT WASHINGTON |
| Zip Code Of The Provider | 190341743 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 126 |
| Number Of Services | 4166 |
| Number Of Medicare Beneficiaries | 2709 |
| Total Submitted Charge Amount | 545391 |
| Total Medicare Allowed Amount | 112846.52 |
| Total Medicare Payment Amount | 86020.8 |
| Total Medicare Standardized Payment Amount | 83546.97 |
| 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 | 126 |
| Number Of Medical Services | 4166 |
| Number Of Medicare Beneficiaries With Medical Services | 2709 |
| Total Medical Submitted Charge Amount | 545391 |
| Total Medical Medicare Allowed Amount | 112846.52 |
| Total Medical Medicare Payment Amount | 86020.8 |
| Total Medical Medicare Standardized Payment Amount | 83546.97 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 316 |
| Number Of Beneficiaries Age 65 to 74 | 907 |
| Number Of Beneficiaries Age 75 to 84 | 772 |
| Number Of Beneficiaries Age Greater 84 | 714 |
| Number Of Female Beneficiaries | 1593 |
| Number Of Male Beneficiaries | 1116 |
| Number Of Non Hispanic White Beneficiaries | 2215 |
| Number Of Black or African American Beneficiaries | 361 |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 51 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2261 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 448 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.8083 |