| National Provider Identifier [NPI]: | 1801999297 |
| Last Name Of The Provider | BREEDLOVE |
| First Name Of The Provider | WILLIAM |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 162 HOSPITAL RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | BLAIRSVILLE |
| Zip Code Of The Provider | 305123139 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 2427 |
| Number Of Medicare Beneficiaries | 444 |
| Total Submitted Charge Amount | 189491 |
| Total Medicare Allowed Amount | 147330.87 |
| Total Medicare Payment Amount | 104516.96 |
| Total Medicare Standardized Payment Amount | 111460.39 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 187 |
| Number Of Medicare Beneficiaries With Drug Services | 97 |
| Total Drug Submitted ChargeAmount | 2019 |
| Total Drug Medicare AllowedAmount | 256.15 |
| Total Drug Medicare PaymentAmount | 187.84 |
| Total Drug Medicare Standardized Payment Amount | 187.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 53 |
| Number Of Medical Services | 2240 |
| Number Of Medicare Beneficiaries With Medical Services | 443 |
| Total Medical Submitted Charge Amount | 187472 |
| Total Medical Medicare Allowed Amount | 147074.72 |
| Total Medical Medicare Payment Amount | 104329.12 |
| Total Medical Medicare Standardized Payment Amount | 111272.55 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 79 |
| Number Of Beneficiaries Age 65 to 74 | 158 |
| Number Of Beneficiaries Age 75 to 84 | 141 |
| Number Of Beneficiaries Age Greater 84 | 66 |
| Number Of Female Beneficiaries | 253 |
| Number Of Male Beneficiaries | 191 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 337 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 107 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 36 |
| Percent Of With Hypertension | 61 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0778 |