National Provider Identifier [NPI]: |
1750482477 |
Last Name Of The Provider |
FREEMAN |
First Name Of The Provider |
MATTHEW |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
645 MCQUEEN SMITH RD N |
Street Address 2 Of The Provider |
SUITE 105 |
City Of The Provider |
PRATTVILLE |
Zip Code Of The Provider |
360667268 |
State Code Of The Provider |
AL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
26 |
Number Of Services |
2192 |
Number Of Medicare Beneficiaries |
293 |
Total Submitted Charge Amount |
123482 |
Total Medicare Allowed Amount |
101261.69 |
Total Medicare Payment Amount |
71542.51 |
Total Medicare Standardized Payment Amount |
78987.59 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
8 |
Number Of Drug Services |
646 |
Number Of Medicare Beneficiaries With Drug Services |
175 |
Total Drug Submitted ChargeAmount |
16708 |
Total Drug Medicare AllowedAmount |
3886.1 |
Total Drug Medicare PaymentAmount |
3414.94 |
Total Drug Medicare Standardized Payment Amount |
3414.94 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
18 |
Number Of Medical Services |
1546 |
Number Of Medicare Beneficiaries With Medical Services |
293 |
Total Medical Submitted Charge Amount |
106774 |
Total Medical Medicare Allowed Amount |
97375.59 |
Total Medical Medicare Payment Amount |
68127.57 |
Total Medical Medicare Standardized Payment Amount |
75572.65 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
35 |
Number Of Beneficiaries Age 65 to 74 |
143 |
Number Of Beneficiaries Age 75 to 84 |
83 |
Number Of Beneficiaries Age Greater 84 |
32 |
Number Of Female Beneficiaries |
168 |
Number Of Male Beneficiaries |
125 |
Number Of Non Hispanic White Beneficiaries |
277 |
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 |
273 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
20 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
13 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
43 |
Percent Of With Hypertension |
58 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0041 |