National Provider Identifier [NPI]: |
1891847893 |
Last Name Of The Provider |
FREIBERG |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
|
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4499 MEDICAL DRIVE |
Street Address 2 Of The Provider |
SUITE 240 METHODIST PLAZA BUILDING |
City Of The Provider |
SAN ANTONIO |
Zip Code Of The Provider |
782293712 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
792 |
Number Of Medicare Beneficiaries |
246 |
Total Submitted Charge Amount |
107285 |
Total Medicare Allowed Amount |
82178.05 |
Total Medicare Payment Amount |
58370.83 |
Total Medicare Standardized Payment Amount |
64176.94 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
2 |
Number Of Drug Services |
32 |
Number Of Medicare Beneficiaries With Drug Services |
32 |
Total Drug Submitted ChargeAmount |
1540 |
Total Drug Medicare AllowedAmount |
1003.85 |
Total Drug Medicare PaymentAmount |
983.7 |
Total Drug Medicare Standardized Payment Amount |
983.7 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
16 |
Number Of Medical Services |
760 |
Number Of Medicare Beneficiaries With Medical Services |
246 |
Total Medical Submitted Charge Amount |
105745 |
Total Medical Medicare Allowed Amount |
81174.2 |
Total Medical Medicare Payment Amount |
57387.13 |
Total Medical Medicare Standardized Payment Amount |
63193.24 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
30 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
131 |
Number Of Male Beneficiaries |
115 |
Number Of Non Hispanic White Beneficiaries |
168 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
60 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
210 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
36 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
28 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
49 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
52 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
15 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
6 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
2.0203 |