| National Provider Identifier [NPI]: | 1801841572 |
| Last Name Of The Provider | BREEDING |
| First Name Of The Provider | VAN |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 226 MEDICAL PLAZA LANE |
| Street Address 2 Of The Provider | |
| City Of The Provider | WHITESBURG |
| Zip Code Of The Provider | 41858 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 143 |
| Number Of Services | 18968 |
| Number Of Medicare Beneficiaries | 1218 |
| Total Submitted Charge Amount | 1428540 |
| Total Medicare Allowed Amount | 500661.85 |
| Total Medicare Payment Amount | 410039.5 |
| Total Medicare Standardized Payment Amount | 429245.45 |
| 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 | 143 |
| Number Of Medical Services | 18968 |
| Number Of Medicare Beneficiaries With Medical Services | 1218 |
| Total Medical Submitted Charge Amount | 1428540 |
| Total Medical Medicare Allowed Amount | 500661.85 |
| Total Medical Medicare Payment Amount | 410039.5 |
| Total Medical Medicare Standardized Payment Amount | 429245.45 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 438 |
| Number Of Beneficiaries Age 65 to 74 | 434 |
| Number Of Beneficiaries Age 75 to 84 | 252 |
| Number Of Beneficiaries Age Greater 84 | 94 |
| Number Of Female Beneficiaries | 619 |
| Number Of Male Beneficiaries | 599 |
| Number Of Non Hispanic White Beneficiaries | 1206 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 709 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 509 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 46 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 53 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.416 |