| National Provider Identifier [NPI]: | 1629233572 |
| Last Name Of The Provider | FREDERICK |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 100 N ACADEMY AVE |
| Street Address 2 Of The Provider | M.C. 20-07 |
| City Of The Provider | DANVILLE |
| Zip Code Of The Provider | 178229800 |
| State Code Of The Provider | PA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 13323 |
| Number Of Medicare Beneficiaries | 3906 |
| Total Submitted Charge Amount | 1859122 |
| Total Medicare Allowed Amount | 213390.76 |
| Total Medicare Payment Amount | 158531.56 |
| Total Medicare Standardized Payment Amount | 169379.79 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 7365 |
| Number Of Medicare Beneficiaries With Drug Services | 78 |
| Total Drug Submitted ChargeAmount | 19754 |
| Total Drug Medicare AllowedAmount | 2005.05 |
| Total Drug Medicare PaymentAmount | 1474.36 |
| Total Drug Medicare Standardized Payment Amount | 1474.36 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 5958 |
| Number Of Medicare Beneficiaries With Medical Services | 3906 |
| Total Medical Submitted Charge Amount | 1839368 |
| Total Medical Medicare Allowed Amount | 211385.71 |
| Total Medical Medicare Payment Amount | 157057.2 |
| Total Medical Medicare Standardized Payment Amount | 167905.43 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 961 |
| Number Of Beneficiaries Age 65 to 74 | 1425 |
| Number Of Beneficiaries Age 75 to 84 | 1019 |
| Number Of Beneficiaries Age Greater 84 | 501 |
| Number Of Female Beneficiaries | 2106 |
| Number Of Male Beneficiaries | 1800 |
| Number Of Non Hispanic White Beneficiaries | 3751 |
| Number Of Black or African American Beneficiaries | 61 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 46 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2618 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1288 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9545 |