| National Provider Identifier [NPI]: | 1841382892 |
| Last Name Of The Provider | FREY |
| First Name Of The Provider | KIRK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 EAST MEDICAL CENTER DR |
| Street Address 2 Of The Provider | B1 FLOOR UNIVERSITY HOSPITAL ROOM B1G412 |
| City Of The Provider | ANN ARBOR |
| Zip Code Of The Provider | 481095028 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nuclear Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 42 |
| Number Of Services | 936 |
| Number Of Medicare Beneficiaries | 821 |
| Total Submitted Charge Amount | 257333 |
| Total Medicare Allowed Amount | 56535.51 |
| Total Medicare Payment Amount | 43430.41 |
| Total Medicare Standardized Payment Amount | 42205.38 |
| 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 | 42 |
| Number Of Medical Services | 936 |
| Number Of Medicare Beneficiaries With Medical Services | 821 |
| Total Medical Submitted Charge Amount | 257333 |
| Total Medical Medicare Allowed Amount | 56535.51 |
| Total Medical Medicare Payment Amount | 43430.41 |
| Total Medical Medicare Standardized Payment Amount | 42205.38 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 149 |
| Number Of Beneficiaries Age 65 to 74 | 395 |
| Number Of Beneficiaries Age 75 to 84 | 209 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 493 |
| Number Of Male Beneficiaries | 328 |
| Number Of Non Hispanic White Beneficiaries | 697 |
| Number Of Black or African American Beneficiaries | 60 |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 22 |
| Number Of Beneficiaries With Medicare Only Entitlement | 666 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 155 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 24 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 46 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.4991 |