| National Provider Identifier [NPI]: | 1770766479 |
| Last Name Of The Provider | BREITERMAN |
| First Name Of The Provider | ANDREW |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 27281 LAS RAMBLAS |
| Street Address 2 Of The Provider | COAST RADIOLOGY IMAGING & INTERVENTION, INC, STE200 |
| City Of The Provider | MISSION VIEJO |
| Zip Code Of The Provider | 92691 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 196 |
| Number Of Services | 6897 |
| Number Of Medicare Beneficiaries | 3517 |
| Total Submitted Charge Amount | 541702.57 |
| Total Medicare Allowed Amount | 177184.08 |
| Total Medicare Payment Amount | 150506.61 |
| Total Medicare Standardized Payment Amount | 140940.49 |
| 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 | 196 |
| Number Of Medical Services | 6897 |
| Number Of Medicare Beneficiaries With Medical Services | 3517 |
| Total Medical Submitted Charge Amount | 541702.57 |
| Total Medical Medicare Allowed Amount | 177184.08 |
| Total Medical Medicare Payment Amount | 150506.61 |
| Total Medical Medicare Standardized Payment Amount | 140940.49 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 194 |
| Number Of Beneficiaries Age 65 to 74 | 1716 |
| Number Of Beneficiaries Age 75 to 84 | 1089 |
| Number Of Beneficiaries Age Greater 84 | 518 |
| Number Of Female Beneficiaries | 2810 |
| Number Of Male Beneficiaries | 707 |
| Number Of Non Hispanic White Beneficiaries | 3108 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 144 |
| Number Of Hispanic Beneficiaries | 169 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 67 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3206 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 311 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 21 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1713 |