| National Provider Identifier [NPI]: | 1093744120 |
| Last Name Of The Provider | FROELICH |
| First Name Of The Provider | JERRY |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 516 DELAWARE ST SE |
| Street Address 2 Of The Provider | UNIV.OF MN PHYSICIANS, PWB FIRST FLOOR, CLINIC 1D |
| City Of The Provider | MINNEAPOLIS |
| Zip Code Of The Provider | 554550356 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 132 |
| Number Of Services | 10032 |
| Number Of Medicare Beneficiaries | 1435 |
| Total Submitted Charge Amount | 1099060.93 |
| Total Medicare Allowed Amount | 258136.68 |
| Total Medicare Payment Amount | 200286.54 |
| Total Medicare Standardized Payment Amount | 206516.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 6697 |
| Number Of Medicare Beneficiaries With Drug Services | 64 |
| Total Drug Submitted ChargeAmount | 7549.93 |
| Total Drug Medicare AllowedAmount | 1930.67 |
| Total Drug Medicare PaymentAmount | 1513.61 |
| Total Drug Medicare Standardized Payment Amount | 1513.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 129 |
| Number Of Medical Services | 3335 |
| Number Of Medicare Beneficiaries With Medical Services | 1435 |
| Total Medical Submitted Charge Amount | 1091511 |
| Total Medical Medicare Allowed Amount | 256206.01 |
| Total Medical Medicare Payment Amount | 198772.93 |
| Total Medical Medicare Standardized Payment Amount | 205002.8 |
| Average Age Of Beneficiaries | 64 |
| Number Of Beneficiaries Age Less65 | 662 |
| Number Of Beneficiaries Age 65 to 74 | 430 |
| Number Of Beneficiaries Age 75 to 84 | 234 |
| Number Of Beneficiaries Age Greater 84 | 109 |
| Number Of Female Beneficiaries | 728 |
| Number Of Male Beneficiaries | 707 |
| Number Of Non Hispanic White Beneficiaries | 1167 |
| Number Of Black or African American Beneficiaries | 135 |
| Number Of AsianPacific Islander Beneficiaries | 44 |
| Number Of Hispanic Beneficiaries | 26 |
| Number Of American Indian Alaska Native Beneficiaries | 38 |
| Number Of Beneficiaries With Race Not Else where Classified | 25 |
| Number Of Beneficiaries With Medicare Only Entitlement | 840 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 595 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 57 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 48 |
| Percent Of With Hypertension | 72 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 2.8572 |