| National Provider Identifier [NPI]: | 1861484644 |
| Last Name Of The Provider | STEWART |
| First Name Of The Provider | FRALEY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 14734 PARK AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHARLEVOIX |
| Zip Code Of The Provider | 497201927 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 366 |
| Number Of Medicare Beneficiaries | 141 |
| Total Submitted Charge Amount | 26772 |
| Total Medicare Allowed Amount | 16984.21 |
| Total Medicare Payment Amount | 12271.86 |
| Total Medicare Standardized Payment Amount | 13408.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 44 |
| Number Of Medicare Beneficiaries With Drug Services | 32 |
| Total Drug Submitted ChargeAmount | 1412 |
| Total Drug Medicare AllowedAmount | 851.47 |
| Total Drug Medicare PaymentAmount | 826.67 |
| Total Drug Medicare Standardized Payment Amount | 826.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 41 |
| Number Of Medical Services | 322 |
| Number Of Medicare Beneficiaries With Medical Services | 141 |
| Total Medical Submitted Charge Amount | 25360 |
| Total Medical Medicare Allowed Amount | 16132.74 |
| Total Medical Medicare Payment Amount | 11445.19 |
| Total Medical Medicare Standardized Payment Amount | 12581.73 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 49 |
| Number Of Beneficiaries Age 75 to 84 | 55 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 62 |
| Number Of Male Beneficiaries | 79 |
| 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 | 124 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 17 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9565 |