National Provider Identifier [NPI]: |
1447217401 |
Last Name Of The Provider |
FREIRE |
First Name Of The Provider |
AMADO |
Middle Initial Of The Provider |
X |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1910 NONCONNAH BLVD |
Street Address 2 Of The Provider |
SUITE 120 |
City Of The Provider |
MEMPHIS |
Zip Code Of The Provider |
381322113 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Pulmonary Disease |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
32 |
Number Of Services |
439 |
Number Of Medicare Beneficiaries |
205 |
Total Submitted Charge Amount |
116167.15 |
Total Medicare Allowed Amount |
45848.81 |
Total Medicare Payment Amount |
34734.88 |
Total Medicare Standardized Payment Amount |
36794.57 |
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 |
32 |
Number Of Medical Services |
439 |
Number Of Medicare Beneficiaries With Medical Services |
205 |
Total Medical Submitted Charge Amount |
116167.15 |
Total Medical Medicare Allowed Amount |
45848.81 |
Total Medical Medicare Payment Amount |
34734.88 |
Total Medical Medicare Standardized Payment Amount |
36794.57 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
81 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
99 |
Number Of Male Beneficiaries |
106 |
Number Of Non Hispanic White Beneficiaries |
126 |
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 |
108 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.8125 |