| National Provider Identifier [NPI]: | 1780672543 |
| Last Name Of The Provider | FREY |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8255 COLLEGE PKWY |
| Street Address 2 Of The Provider | STE 100 |
| City Of The Provider | FORT MYERS |
| Zip Code Of The Provider | 339195119 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Interventional Pain Management |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 122 |
| Number Of Services | 86341 |
| Number Of Medicare Beneficiaries | 1687 |
| Total Submitted Charge Amount | 9559775.03 |
| Total Medicare Allowed Amount | 3153415.56 |
| Total Medicare Payment Amount | 2628187.73 |
| Total Medicare Standardized Payment Amount | 2348425.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 37989 |
| Number Of Medicare Beneficiaries With Drug Services | 621 |
| Total Drug Submitted ChargeAmount | 645956.96 |
| Total Drug Medicare AllowedAmount | 236464.99 |
| Total Drug Medicare PaymentAmount | 184976.86 |
| Total Drug Medicare Standardized Payment Amount | 184976.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 105 |
| Number Of Medical Services | 48352 |
| Number Of Medicare Beneficiaries With Medical Services | 1686 |
| Total Medical Submitted Charge Amount | 8913818.07 |
| Total Medical Medicare Allowed Amount | 2916950.57 |
| Total Medical Medicare Payment Amount | 2443210.87 |
| Total Medical Medicare Standardized Payment Amount | 2163448.55 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 489 |
| Number Of Beneficiaries Age 65 to 74 | 607 |
| Number Of Beneficiaries Age 75 to 84 | 385 |
| Number Of Beneficiaries Age Greater 84 | 206 |
| Number Of Female Beneficiaries | 997 |
| Number Of Male Beneficiaries | 690 |
| Number Of Non Hispanic White Beneficiaries | 1513 |
| Number Of Black or African American Beneficiaries | 44 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 96 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1321 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 366 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 70 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.4806 |