National Provider Identifier [NPI]: |
1730157066 |
Last Name Of The Provider |
FREED |
First Name Of The Provider |
DANIEL |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
OD, MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2323 MEMORIAL AVE |
Street Address 2 Of The Provider |
SUITE 10 |
City Of The Provider |
LYNCHBURG |
Zip Code Of The Provider |
245012661 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
30 |
Number Of Services |
657 |
Number Of Medicare Beneficiaries |
335 |
Total Submitted Charge Amount |
120709.56 |
Total Medicare Allowed Amount |
73758.53 |
Total Medicare Payment Amount |
56916.45 |
Total Medicare Standardized Payment Amount |
58383.4 |
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 |
30 |
Number Of Medical Services |
657 |
Number Of Medicare Beneficiaries With Medical Services |
335 |
Total Medical Submitted Charge Amount |
120709.56 |
Total Medical Medicare Allowed Amount |
73758.53 |
Total Medical Medicare Payment Amount |
56916.45 |
Total Medical Medicare Standardized Payment Amount |
58383.4 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
78 |
Number Of Beneficiaries Age 75 to 84 |
109 |
Number Of Beneficiaries Age Greater 84 |
89 |
Number Of Female Beneficiaries |
203 |
Number Of Male Beneficiaries |
132 |
Number Of Non Hispanic White Beneficiaries |
304 |
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 |
222 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
113 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
36 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
36 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.706 |