| National Provider Identifier [NPI]: | 1215934203 |
| Last Name Of The Provider | FREDRICKSON |
| First Name Of The Provider | DANN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5400 N OAK TRFY |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | KANSAS CITY |
| Zip Code Of The Provider | 641184688 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 4163 |
| Number Of Medicare Beneficiaries | 832 |
| Total Submitted Charge Amount | 349303 |
| Total Medicare Allowed Amount | 216886.21 |
| Total Medicare Payment Amount | 153576.2 |
| Total Medicare Standardized Payment Amount | 159418.78 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 322 |
| Number Of Medicare Beneficiaries With Drug Services | 193 |
| Total Drug Submitted ChargeAmount | 10741 |
| Total Drug Medicare AllowedAmount | 6436.98 |
| Total Drug Medicare PaymentAmount | 6054.75 |
| Total Drug Medicare Standardized Payment Amount | 6054.75 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 3841 |
| Number Of Medicare Beneficiaries With Medical Services | 832 |
| Total Medical Submitted Charge Amount | 338562 |
| Total Medical Medicare Allowed Amount | 210449.23 |
| Total Medical Medicare Payment Amount | 147521.45 |
| Total Medical Medicare Standardized Payment Amount | 153364.03 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 71 |
| Number Of Beneficiaries Age 65 to 74 | 337 |
| Number Of Beneficiaries Age 75 to 84 | 271 |
| Number Of Beneficiaries Age Greater 84 | 153 |
| Number Of Female Beneficiaries | 474 |
| Number Of Male Beneficiaries | 358 |
| Number Of Non Hispanic White Beneficiaries | 785 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 18 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 771 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 61 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1498 |