National Provider Identifier [NPI]: |
1841306651 |
Last Name Of The Provider |
FRIERSON |
First Name Of The Provider |
ERNEST |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8950 DR. MARTIN LUTHER KING JR. STREET NORTH |
Street Address 2 Of The Provider |
#180 |
City Of The Provider |
ST. PETERSBURG |
Zip Code Of The Provider |
337023001 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
27 |
Number Of Services |
632 |
Number Of Medicare Beneficiaries |
147 |
Total Submitted Charge Amount |
62939 |
Total Medicare Allowed Amount |
41676.01 |
Total Medicare Payment Amount |
29988.54 |
Total Medicare Standardized Payment Amount |
30102.1 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
76 |
Number Of Medicare Beneficiaries With Drug Services |
59 |
Total Drug Submitted ChargeAmount |
2192 |
Total Drug Medicare AllowedAmount |
1475.15 |
Total Drug Medicare PaymentAmount |
1438.25 |
Total Drug Medicare Standardized Payment Amount |
1438.25 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
19 |
Number Of Medical Services |
556 |
Number Of Medicare Beneficiaries With Medical Services |
147 |
Total Medical Submitted Charge Amount |
60747 |
Total Medical Medicare Allowed Amount |
40200.86 |
Total Medical Medicare Payment Amount |
28550.29 |
Total Medical Medicare Standardized Payment Amount |
28663.85 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
52 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
81 |
Number Of Male Beneficiaries |
66 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
131 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
16 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
|
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
36 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2578 |