| National Provider Identifier [NPI]: | 1487755641 |
| Last Name Of The Provider | BREELAND |
| First Name Of The Provider | DONNA |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1020 RIVER OAKS DR |
| Street Address 2 Of The Provider | SUITE 320 |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 392329500 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Obstetrics/Gynecology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 1514 |
| Number Of Medicare Beneficiaries | 250 |
| Total Submitted Charge Amount | 93526.24 |
| Total Medicare Allowed Amount | 45894.88 |
| Total Medicare Payment Amount | 39276.97 |
| Total Medicare Standardized Payment Amount | 46269.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 639 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 10150 |
| Total Drug Medicare AllowedAmount | 7064.26 |
| Total Drug Medicare PaymentAmount | 5534.93 |
| Total Drug Medicare Standardized Payment Amount | 5534.93 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 875 |
| Number Of Medicare Beneficiaries With Medical Services | 249 |
| Total Medical Submitted Charge Amount | 83376.24 |
| Total Medical Medicare Allowed Amount | 38830.62 |
| Total Medical Medicare Payment Amount | 33742.04 |
| Total Medical Medicare Standardized Payment Amount | 40734.71 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 175 |
| Number Of Beneficiaries Age 75 to 84 | 51 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 250 |
| Number Of Male Beneficiaries | 0 |
| Number Of Non Hispanic White Beneficiaries | 232 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | 5 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 13 |
| Percent Of With Hyperlipidemia | 34 |
| Percent Of With Hypertension | 45 |
| Percent Of With Ischemic Heart Disease | 12 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 27 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.6025 |