National Provider Identifier [NPI]: |
1215995246 |
Last Name Of The Provider |
FREY |
First Name Of The Provider |
CLAUDE |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
11209 N TATUM BLVD |
Street Address 2 Of The Provider |
SUITE #110 |
City Of The Provider |
PHOENIX |
Zip Code Of The Provider |
850283091 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
232 |
Number Of Services |
2366 |
Number Of Medicare Beneficiaries |
1493 |
Total Submitted Charge Amount |
462554.25 |
Total Medicare Allowed Amount |
102390.13 |
Total Medicare Payment Amount |
79245.43 |
Total Medicare Standardized Payment Amount |
80184.63 |
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 |
232 |
Number Of Medical Services |
2366 |
Number Of Medicare Beneficiaries With Medical Services |
1493 |
Total Medical Submitted Charge Amount |
462554.25 |
Total Medical Medicare Allowed Amount |
102390.13 |
Total Medical Medicare Payment Amount |
79245.43 |
Total Medical Medicare Standardized Payment Amount |
80184.63 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
241 |
Number Of Beneficiaries Age 65 to 74 |
607 |
Number Of Beneficiaries Age 75 to 84 |
406 |
Number Of Beneficiaries Age Greater 84 |
239 |
Number Of Female Beneficiaries |
788 |
Number Of Male Beneficiaries |
705 |
Number Of Non Hispanic White Beneficiaries |
1176 |
Number Of Black or African American Beneficiaries |
78 |
Number Of AsianPacific Islander Beneficiaries |
21 |
Number Of Hispanic Beneficiaries |
168 |
Number Of American Indian Alaska Native Beneficiaries |
32 |
Number Of Beneficiaries With Race Not Else where Classified |
18 |
Number Of Beneficiaries With Medicare Only Entitlement |
1147 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
346 |
Percent Of With Atrial Fibrillation |
21 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
33 |
Percent Of With Chronic Kidney Disease |
47 |
Percent Of With Chronic Obstructive Pulmonary Disease |
28 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
51 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
1.9471 |