National Provider Identifier [NPI]: |
1306823695 |
Last Name Of The Provider |
FREYHOF |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3535 SOUTHERN BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
KETTERING |
Zip Code Of The Provider |
454291221 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
626 |
Number Of Medicare Beneficiaries |
550 |
Total Submitted Charge Amount |
379862 |
Total Medicare Allowed Amount |
93171.91 |
Total Medicare Payment Amount |
68802.56 |
Total Medicare Standardized Payment Amount |
69486.64 |
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 |
26 |
Number Of Medical Services |
626 |
Number Of Medicare Beneficiaries With Medical Services |
550 |
Total Medical Submitted Charge Amount |
379862 |
Total Medical Medicare Allowed Amount |
93171.91 |
Total Medical Medicare Payment Amount |
68802.56 |
Total Medical Medicare Standardized Payment Amount |
69486.64 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
143 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
138 |
Number Of Beneficiaries Age Greater 84 |
102 |
Number Of Female Beneficiaries |
321 |
Number Of Male Beneficiaries |
229 |
Number Of Non Hispanic White Beneficiaries |
515 |
Number Of Black or African American Beneficiaries |
21 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
384 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
166 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
17 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
39 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
44 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
54 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.8855 |