| National Provider Identifier [NPI]: | 1881690345 |
| Last Name Of The Provider | BREEZE |
| First Name Of The Provider | SCOTT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1517 THOMPSON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | RICHMOND |
| Zip Code Of The Provider | 774694932 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 2278 |
| Number Of Medicare Beneficiaries | 243 |
| Total Submitted Charge Amount | 432920.4 |
| Total Medicare Allowed Amount | 112057.04 |
| Total Medicare Payment Amount | 82296.23 |
| Total Medicare Standardized Payment Amount | 86911.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 1254 |
| Number Of Medicare Beneficiaries With Drug Services | 108 |
| Total Drug Submitted ChargeAmount | 39845.4 |
| Total Drug Medicare AllowedAmount | 13398.38 |
| Total Drug Medicare PaymentAmount | 10445.87 |
| Total Drug Medicare Standardized Payment Amount | 10445.87 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 1024 |
| Number Of Medicare Beneficiaries With Medical Services | 243 |
| Total Medical Submitted Charge Amount | 393075 |
| Total Medical Medicare Allowed Amount | 98658.66 |
| Total Medical Medicare Payment Amount | 71850.36 |
| Total Medical Medicare Standardized Payment Amount | 76465.21 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 117 |
| Number Of Beneficiaries Age 75 to 84 | 75 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 154 |
| Number Of Male Beneficiaries | 89 |
| Number Of Non Hispanic White Beneficiaries | 180 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 39 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 197 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 46 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0397 |