| National Provider Identifier [NPI]: | 1639382302 |
| Last Name Of The Provider | BREDEWEG |
| First Name Of The Provider | RYAN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1304 FAWCETT AVE |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | TACOMA |
| Zip Code Of The Provider | 984021911 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 203 |
| Number Of Services | 5935 |
| Number Of Medicare Beneficiaries | 1826 |
| Total Submitted Charge Amount | 680160.5 |
| Total Medicare Allowed Amount | 183585.02 |
| Total Medicare Payment Amount | 138806.35 |
| Total Medicare Standardized Payment Amount | 142103.62 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 2993 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 1511 |
| Total Drug Medicare AllowedAmount | 563.39 |
| Total Drug Medicare PaymentAmount | 432.39 |
| Total Drug Medicare Standardized Payment Amount | 432.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 201 |
| Number Of Medical Services | 2942 |
| Number Of Medicare Beneficiaries With Medical Services | 1826 |
| Total Medical Submitted Charge Amount | 678649.5 |
| Total Medical Medicare Allowed Amount | 183021.63 |
| Total Medical Medicare Payment Amount | 138373.96 |
| Total Medical Medicare Standardized Payment Amount | 141671.23 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 408 |
| Number Of Beneficiaries Age 65 to 74 | 661 |
| Number Of Beneficiaries Age 75 to 84 | 496 |
| Number Of Beneficiaries Age Greater 84 | 261 |
| Number Of Female Beneficiaries | 1002 |
| Number Of Male Beneficiaries | 824 |
| Number Of Non Hispanic White Beneficiaries | 1368 |
| Number Of Black or African American Beneficiaries | 169 |
| Number Of AsianPacific Islander Beneficiaries | 155 |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | 32 |
| Number Of Beneficiaries With Race Not Else where Classified | 51 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1209 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 617 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 18 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 49 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 45 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.2463 |