| National Provider Identifier [NPI]: | 1932337052 |
| Last Name Of The Provider | FREY |
| First Name Of The Provider | LANE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2500 N STATE ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 392164500 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Endocrinology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 396 |
| Number Of Medicare Beneficiaries | 150 |
| Total Submitted Charge Amount | 67929 |
| Total Medicare Allowed Amount | 27780.66 |
| Total Medicare Payment Amount | 21134.59 |
| Total Medicare Standardized Payment Amount | 23337.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 22 |
| Number Of Medicare Beneficiaries With Drug Services | 22 |
| Total Drug Submitted ChargeAmount | 1238 |
| Total Drug Medicare AllowedAmount | 462.72 |
| Total Drug Medicare PaymentAmount | 415.62 |
| Total Drug Medicare Standardized Payment Amount | 415.62 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 15 |
| Number Of Medical Services | 374 |
| Number Of Medicare Beneficiaries With Medical Services | 150 |
| Total Medical Submitted Charge Amount | 66691 |
| Total Medical Medicare Allowed Amount | 27317.94 |
| Total Medical Medicare Payment Amount | 20718.97 |
| Total Medical Medicare Standardized Payment Amount | 22922.23 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 43 |
| Number Of Beneficiaries Age 65 to 74 | 72 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 106 |
| Number Of Male Beneficiaries | 44 |
| Number Of Non Hispanic White Beneficiaries | 128 |
| 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 | 113 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 37 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 69 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.2082 |