| National Provider Identifier [NPI]: | 1679738504 |
| Last Name Of The Provider | FRY |
| First Name Of The Provider | ROBERT |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1225 N H ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | LOMPOC |
| Zip Code Of The Provider | 934363301 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 3585 |
| Number Of Medicare Beneficiaries | 383 |
| Total Submitted Charge Amount | 329142.25 |
| Total Medicare Allowed Amount | 137739.83 |
| Total Medicare Payment Amount | 102817.54 |
| Total Medicare Standardized Payment Amount | 100550.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 2549 |
| Number Of Medicare Beneficiaries With Drug Services | 195 |
| Total Drug Submitted ChargeAmount | 28368 |
| Total Drug Medicare AllowedAmount | 13285.3 |
| Total Drug Medicare PaymentAmount | 10055.44 |
| Total Drug Medicare Standardized Payment Amount | 10055.44 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 1036 |
| Number Of Medicare Beneficiaries With Medical Services | 383 |
| Total Medical Submitted Charge Amount | 300774.25 |
| Total Medical Medicare Allowed Amount | 124454.53 |
| Total Medical Medicare Payment Amount | 92762.1 |
| Total Medical Medicare Standardized Payment Amount | 90495.13 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 149 |
| Number Of Beneficiaries Age 75 to 84 | 127 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 246 |
| Number Of Male Beneficiaries | 137 |
| Number Of Non Hispanic White Beneficiaries | 258 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 84 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 285 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 98 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 37 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.2248 |