| National Provider Identifier [NPI]: | 1013052463 |
| Last Name Of The Provider | FREYTAG |
| First Name Of The Provider | ADDIE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | FNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1236 KNOXVILLE HWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | WARTBURG |
| Zip Code Of The Provider | 37887 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 43 |
| Number Of Services | 1379 |
| Number Of Medicare Beneficiaries | 160 |
| Total Submitted Charge Amount | 104915.06 |
| Total Medicare Allowed Amount | 65773.64 |
| Total Medicare Payment Amount | 46733.83 |
| Total Medicare Standardized Payment Amount | 59148.92 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 255 |
| Number Of Medicare Beneficiaries With Drug Services | 61 |
| Total Drug Submitted ChargeAmount | 5178 |
| Total Drug Medicare AllowedAmount | 814.54 |
| Total Drug Medicare PaymentAmount | 685.57 |
| Total Drug Medicare Standardized Payment Amount | 685.57 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 29 |
| Number Of Medical Services | 1124 |
| Number Of Medicare Beneficiaries With Medical Services | 160 |
| Total Medical Submitted Charge Amount | 99737.06 |
| Total Medical Medicare Allowed Amount | 64959.1 |
| Total Medical Medicare Payment Amount | 46048.26 |
| Total Medical Medicare Standardized Payment Amount | 58463.35 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 68 |
| Number Of Beneficiaries Age 65 to 74 | 59 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 80 |
| Number Of Male Beneficiaries | 80 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 63 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 97 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2766 |