| National Provider Identifier [NPI]: | 1407056054 |
| Last Name Of The Provider | FRITZ |
| First Name Of The Provider | JAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3503 N CHARLES ST APT 3D |
| Street Address 2 Of The Provider | |
| City Of The Provider | BALTIMORE |
| Zip Code Of The Provider | 212182412 |
| State Code Of The Provider | MD |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 127 |
| Number Of Services | 2289 |
| Number Of Medicare Beneficiaries | 1454 |
| Total Submitted Charge Amount | 449370.3 |
| Total Medicare Allowed Amount | 93809.48 |
| Total Medicare Payment Amount | 70138.5 |
| Total Medicare Standardized Payment Amount | 67030.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 13 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 950.3 |
| Total Drug Medicare AllowedAmount | 8.73 |
| Total Drug Medicare PaymentAmount | 6.82 |
| Total Drug Medicare Standardized Payment Amount | 6.82 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 124 |
| Number Of Medical Services | 2276 |
| Number Of Medicare Beneficiaries With Medical Services | 1454 |
| Total Medical Submitted Charge Amount | 448420 |
| Total Medical Medicare Allowed Amount | 93800.75 |
| Total Medical Medicare Payment Amount | 70131.68 |
| Total Medical Medicare Standardized Payment Amount | 67023.32 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 423 |
| Number Of Beneficiaries Age 65 to 74 | 563 |
| Number Of Beneficiaries Age 75 to 84 | 317 |
| Number Of Beneficiaries Age Greater 84 | 151 |
| Number Of Female Beneficiaries | 807 |
| Number Of Male Beneficiaries | 647 |
| Number Of Non Hispanic White Beneficiaries | 944 |
| Number Of Black or African American Beneficiaries | 425 |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1027 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 427 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 58 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 2.3691 |