| National Provider Identifier [NPI]: | 1396949111 |
| Last Name Of The Provider | FRALEY |
| First Name Of The Provider | NICHOLAS |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 12112 RANCHO VISTOSO BLVD 150-221 |
| Street Address 2 Of The Provider | |
| City Of The Provider | TUCSON |
| Zip Code Of The Provider | 85755 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 140 |
| Number Of Services | 4009 |
| Number Of Medicare Beneficiaries | 1688 |
| Total Submitted Charge Amount | 457035 |
| Total Medicare Allowed Amount | 138599.84 |
| Total Medicare Payment Amount | 104209.12 |
| Total Medicare Standardized Payment Amount | 106249.22 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1485 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 4455 |
| Total Drug Medicare AllowedAmount | 278.55 |
| Total Drug Medicare PaymentAmount | 218.33 |
| Total Drug Medicare Standardized Payment Amount | 218.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 139 |
| Number Of Medical Services | 2524 |
| Number Of Medicare Beneficiaries With Medical Services | 1688 |
| Total Medical Submitted Charge Amount | 452580 |
| Total Medical Medicare Allowed Amount | 138321.29 |
| Total Medical Medicare Payment Amount | 103990.79 |
| Total Medical Medicare Standardized Payment Amount | 106030.89 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 180 |
| Number Of Beneficiaries Age 65 to 74 | 628 |
| Number Of Beneficiaries Age 75 to 84 | 583 |
| Number Of Beneficiaries Age Greater 84 | 297 |
| Number Of Female Beneficiaries | 961 |
| Number Of Male Beneficiaries | 727 |
| Number Of Non Hispanic White Beneficiaries | 1204 |
| Number Of Black or African American Beneficiaries | 36 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 360 |
| Number Of American Indian Alaska Native Beneficiaries | 69 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1291 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 397 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.6448 |