| National Provider Identifier [NPI]: | 1427137637 |
| Last Name Of The Provider | FRIBUSH |
| First Name Of The Provider | ELLIS |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 510 NORTH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | PITTSFIELD |
| Zip Code Of The Provider | 01201 |
| State Code Of The Provider | MA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 54 |
| Number Of Services | 7920 |
| Number Of Medicare Beneficiaries | 1885 |
| Total Submitted Charge Amount | 615905 |
| Total Medicare Allowed Amount | 399893.13 |
| Total Medicare Payment Amount | 296202.17 |
| Total Medicare Standardized Payment Amount | 292305.07 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 602 |
| Number Of Medicare Beneficiaries With Drug Services | 596 |
| Total Drug Submitted ChargeAmount | 15535 |
| Total Drug Medicare AllowedAmount | 9798.19 |
| Total Drug Medicare PaymentAmount | 9514.98 |
| Total Drug Medicare Standardized Payment Amount | 9514.98 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 49 |
| Number Of Medical Services | 7318 |
| Number Of Medicare Beneficiaries With Medical Services | 1881 |
| Total Medical Submitted Charge Amount | 600370 |
| Total Medical Medicare Allowed Amount | 390094.94 |
| Total Medical Medicare Payment Amount | 286687.19 |
| Total Medical Medicare Standardized Payment Amount | 282790.09 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 316 |
| Number Of Beneficiaries Age 65 to 74 | 592 |
| Number Of Beneficiaries Age 75 to 84 | 614 |
| Number Of Beneficiaries Age Greater 84 | 363 |
| Number Of Female Beneficiaries | 1048 |
| Number Of Male Beneficiaries | 837 |
| Number Of Non Hispanic White Beneficiaries | 1819 |
| Number Of Black or African American Beneficiaries | 31 |
| 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 | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1435 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 450 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 28 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0873 |