| National Provider Identifier [NPI]: | 1538373485 |
| Last Name Of The Provider | FRY |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 310 E WALNUT ST |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | GARDEN CITY |
| Zip Code Of The Provider | 678465560 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 67 |
| Number Of Services | 3711 |
| Number Of Medicare Beneficiaries | 853 |
| Total Submitted Charge Amount | 1503434 |
| Total Medicare Allowed Amount | 567727.82 |
| Total Medicare Payment Amount | 427928.24 |
| Total Medicare Standardized Payment Amount | 432013.31 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 900 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 4950 |
| Total Drug Medicare AllowedAmount | 4916.79 |
| Total Drug Medicare PaymentAmount | 3565.92 |
| Total Drug Medicare Standardized Payment Amount | 3565.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 66 |
| Number Of Medical Services | 2811 |
| Number Of Medicare Beneficiaries With Medical Services | 853 |
| Total Medical Submitted Charge Amount | 1498484 |
| Total Medical Medicare Allowed Amount | 562811.03 |
| Total Medical Medicare Payment Amount | 424362.32 |
| Total Medical Medicare Standardized Payment Amount | 428447.39 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 41 |
| Number Of Beneficiaries Age 65 to 74 | 316 |
| Number Of Beneficiaries Age 75 to 84 | 373 |
| Number Of Beneficiaries Age Greater 84 | 123 |
| Number Of Female Beneficiaries | 492 |
| Number Of Male Beneficiaries | 361 |
| Number Of Non Hispanic White Beneficiaries | 760 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 743 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 110 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 16 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 30 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0059 |