National Provider Identifier [NPI]: |
1962439505 |
Last Name Of The Provider |
FREIWALD |
First Name Of The Provider |
SCOTT |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4077 FIFTH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAN DIEGO |
Zip Code Of The Provider |
921032105 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
626 |
Number Of Medicare Beneficiaries |
420 |
Total Submitted Charge Amount |
290675 |
Total Medicare Allowed Amount |
70996.37 |
Total Medicare Payment Amount |
55050.13 |
Total Medicare Standardized Payment Amount |
54434.41 |
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 |
33 |
Number Of Medical Services |
626 |
Number Of Medicare Beneficiaries With Medical Services |
420 |
Total Medical Submitted Charge Amount |
290675 |
Total Medical Medicare Allowed Amount |
70996.37 |
Total Medical Medicare Payment Amount |
55050.13 |
Total Medical Medicare Standardized Payment Amount |
54434.41 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
145 |
Number Of Beneficiaries Age 65 to 74 |
114 |
Number Of Beneficiaries Age 75 to 84 |
92 |
Number Of Beneficiaries Age Greater 84 |
69 |
Number Of Female Beneficiaries |
213 |
Number Of Male Beneficiaries |
207 |
Number Of Non Hispanic White Beneficiaries |
253 |
Number Of Black or African American Beneficiaries |
58 |
Number Of AsianPacific Islander Beneficiaries |
21 |
Number Of Hispanic Beneficiaries |
77 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
180 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
240 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
26 |
Percent Of With Depression |
45 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
23 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.3 |