| National Provider Identifier [NPI]: | 1750337499 |
| Last Name Of The Provider | FREYTES |
| First Name Of The Provider | JOSE |
| Middle Initial Of The Provider | I |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12625 MEMORIAL DR APT 154 |
| Street Address 2 Of The Provider | |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770244878 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 127 |
| Number Of Services | 6303 |
| Number Of Medicare Beneficiaries | 1524 |
| Total Submitted Charge Amount | 224887.78 |
| Total Medicare Allowed Amount | 86591.26 |
| Total Medicare Payment Amount | 63904.85 |
| Total Medicare Standardized Payment Amount | 64920.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 4025 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 3852.56 |
| Total Drug Medicare AllowedAmount | 978.37 |
| Total Drug Medicare PaymentAmount | 767.06 |
| Total Drug Medicare Standardized Payment Amount | 767.06 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 123 |
| Number Of Medical Services | 2278 |
| Number Of Medicare Beneficiaries With Medical Services | 1524 |
| Total Medical Submitted Charge Amount | 221035.22 |
| Total Medical Medicare Allowed Amount | 85612.89 |
| Total Medical Medicare Payment Amount | 63137.79 |
| Total Medical Medicare Standardized Payment Amount | 64153.49 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 334 |
| Number Of Beneficiaries Age 65 to 74 | 593 |
| Number Of Beneficiaries Age 75 to 84 | 407 |
| Number Of Beneficiaries Age Greater 84 | 190 |
| Number Of Female Beneficiaries | 843 |
| Number Of Male Beneficiaries | 681 |
| Number Of Non Hispanic White Beneficiaries | 859 |
| Number Of Black or African American Beneficiaries | 342 |
| Number Of AsianPacific Islander Beneficiaries | 33 |
| Number Of Hispanic Beneficiaries | 278 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1027 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 497 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 39 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9583 |