| National Provider Identifier [NPI]: | 1427042449 |
| Last Name Of The Provider | FRY |
| First Name Of The Provider | DENNIS |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5950 UNIVERSITY AVE |
| Street Address 2 Of The Provider | STE 231 |
| City Of The Provider | WEST DES MOINES |
| Zip Code Of The Provider | 502668216 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 128 |
| Number Of Services | 2769 |
| Number Of Medicare Beneficiaries | 1270 |
| Total Submitted Charge Amount | 2489461.5 |
| Total Medicare Allowed Amount | 798151.72 |
| Total Medicare Payment Amount | 617669.43 |
| Total Medicare Standardized Payment Amount | 691538.09 |
| 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 | 128 |
| Number Of Medical Services | 2769 |
| Number Of Medicare Beneficiaries With Medical Services | 1270 |
| Total Medical Submitted Charge Amount | 2489461.5 |
| Total Medical Medicare Allowed Amount | 798151.72 |
| Total Medical Medicare Payment Amount | 617669.43 |
| Total Medical Medicare Standardized Payment Amount | 691538.09 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 149 |
| Number Of Beneficiaries Age 65 to 74 | 478 |
| Number Of Beneficiaries Age 75 to 84 | 435 |
| Number Of Beneficiaries Age Greater 84 | 208 |
| Number Of Female Beneficiaries | 680 |
| Number Of Male Beneficiaries | 590 |
| Number Of Non Hispanic White Beneficiaries | 1195 |
| Number Of Black or African American Beneficiaries | 43 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1048 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 222 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 2.0693 |