| National Provider Identifier [NPI]: | 1780767459 |
| Last Name Of The Provider | MAUSOLF |
| First Name Of The Provider | FREDERICK |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4645 NORMAL BLVD |
| Street Address 2 Of The Provider | SUITE 245 |
| City Of The Provider | LINCOLN |
| Zip Code Of The Provider | 685065817 |
| State Code Of The Provider | NE |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 59 |
| Number Of Services | 2975 |
| Number Of Medicare Beneficiaries | 1145 |
| Total Submitted Charge Amount | 1276706 |
| Total Medicare Allowed Amount | 398952.45 |
| Total Medicare Payment Amount | 286759.89 |
| Total Medicare Standardized Payment Amount | 293442.68 |
| 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 | 59 |
| Number Of Medical Services | 2975 |
| Number Of Medicare Beneficiaries With Medical Services | 1145 |
| Total Medical Submitted Charge Amount | 1276706 |
| Total Medical Medicare Allowed Amount | 398952.45 |
| Total Medical Medicare Payment Amount | 286759.89 |
| Total Medical Medicare Standardized Payment Amount | 293442.68 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 53 |
| Number Of Beneficiaries Age 65 to 74 | 406 |
| Number Of Beneficiaries Age 75 to 84 | 411 |
| Number Of Beneficiaries Age Greater 84 | 275 |
| Number Of Female Beneficiaries | 703 |
| Number Of Male Beneficiaries | 442 |
| Number Of Non Hispanic White Beneficiaries | 1102 |
| Number Of Black or African American Beneficiaries | |
| 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 | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1058 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 87 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 23 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9746 |