National Provider Identifier [NPI]: |
1316976152 |
Last Name Of The Provider |
FREEDMAN |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
680 GUZZI LN STE 203 |
Street Address 2 Of The Provider |
|
City Of The Provider |
SONORA |
Zip Code Of The Provider |
953705288 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Urology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
95 |
Number Of Services |
17010 |
Number Of Medicare Beneficiaries |
1364 |
Total Submitted Charge Amount |
1482701.86 |
Total Medicare Allowed Amount |
800020.53 |
Total Medicare Payment Amount |
593009.93 |
Total Medicare Standardized Payment Amount |
585511.82 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
7594 |
Number Of Medicare Beneficiaries With Drug Services |
59 |
Total Drug Submitted ChargeAmount |
147780 |
Total Drug Medicare AllowedAmount |
64304.12 |
Total Drug Medicare PaymentAmount |
49762.08 |
Total Drug Medicare Standardized Payment Amount |
49762.08 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
91 |
Number Of Medical Services |
9416 |
Number Of Medicare Beneficiaries With Medical Services |
1364 |
Total Medical Submitted Charge Amount |
1334921.86 |
Total Medical Medicare Allowed Amount |
735716.41 |
Total Medical Medicare Payment Amount |
543247.85 |
Total Medical Medicare Standardized Payment Amount |
535749.74 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
86 |
Number Of Beneficiaries Age 65 to 74 |
580 |
Number Of Beneficiaries Age 75 to 84 |
518 |
Number Of Beneficiaries Age Greater 84 |
180 |
Number Of Female Beneficiaries |
357 |
Number Of Male Beneficiaries |
1007 |
Number Of Non Hispanic White Beneficiaries |
1283 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
48 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
1239 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
125 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
22 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.115 |