| National Provider Identifier [NPI]: | 1225098106 |
| Last Name Of The Provider | MEOLI |
| First Name Of The Provider | FREDERICK |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13355 E 10 MILE RD |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT DR. MEOLI |
| City Of The Provider | WARREN |
| Zip Code Of The Provider | 480892048 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 202 |
| Number Of Services | 4235 |
| Number Of Medicare Beneficiaries | 2097 |
| Total Submitted Charge Amount | 381931.88 |
| Total Medicare Allowed Amount | 116958.23 |
| Total Medicare Payment Amount | 90675.25 |
| Total Medicare Standardized Payment Amount | 92741.39 |
| 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 | 202 |
| Number Of Medical Services | 4235 |
| Number Of Medicare Beneficiaries With Medical Services | 2097 |
| Total Medical Submitted Charge Amount | 381931.88 |
| Total Medical Medicare Allowed Amount | 116958.23 |
| Total Medical Medicare Payment Amount | 90675.25 |
| Total Medical Medicare Standardized Payment Amount | 92741.39 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 445 |
| Number Of Beneficiaries Age 65 to 74 | 745 |
| Number Of Beneficiaries Age 75 to 84 | 577 |
| Number Of Beneficiaries Age Greater 84 | 330 |
| Number Of Female Beneficiaries | 1313 |
| Number Of Male Beneficiaries | 784 |
| Number Of Non Hispanic White Beneficiaries | 1953 |
| Number Of Black or African American Beneficiaries | 109 |
| 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 | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1501 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 596 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5215 |