| National Provider Identifier [NPI]: | 1063481281 |
| Last Name Of The Provider | BREAKEY |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4940 W CLARK RD |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | YPSILANTI |
| Zip Code Of The Provider | 481970860 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 34 |
| Number Of Services | 935 |
| Number Of Medicare Beneficiaries | 235 |
| Total Submitted Charge Amount | 99071 |
| Total Medicare Allowed Amount | 68961.83 |
| Total Medicare Payment Amount | 48823.51 |
| Total Medicare Standardized Payment Amount | 47601.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 99 |
| Number Of Medicare Beneficiaries With Drug Services | 93 |
| Total Drug Submitted ChargeAmount | 2604 |
| Total Drug Medicare AllowedAmount | 2030.84 |
| Total Drug Medicare PaymentAmount | 1989.66 |
| Total Drug Medicare Standardized Payment Amount | 1989.66 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 836 |
| Number Of Medicare Beneficiaries With Medical Services | 235 |
| Total Medical Submitted Charge Amount | 96467 |
| Total Medical Medicare Allowed Amount | 66930.99 |
| Total Medical Medicare Payment Amount | 46833.85 |
| Total Medical Medicare Standardized Payment Amount | 45612 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 109 |
| Number Of Beneficiaries Age 75 to 84 | 68 |
| Number Of Beneficiaries Age Greater 84 | 25 |
| Number Of Female Beneficiaries | 121 |
| Number Of Male Beneficiaries | 114 |
| Number Of Non Hispanic White Beneficiaries | 178 |
| Number Of Black or African American Beneficiaries | 41 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 217 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 18 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 24 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.0045 |