| National Provider Identifier [NPI]: | 1710976766 |
| Last Name Of The Provider | FREDENBERG |
| First Name Of The Provider | PATRICK |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2323 W ROSE GARDEN LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | PHOENIX |
| Zip Code Of The Provider | 850272530 |
| State Code Of The Provider | AZ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 182 |
| Number Of Services | 48529 |
| Number Of Medicare Beneficiaries | 3159 |
| Total Submitted Charge Amount | 3064555 |
| Total Medicare Allowed Amount | 775065.21 |
| Total Medicare Payment Amount | 584957.17 |
| Total Medicare Standardized Payment Amount | 606725.36 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 43114 |
| Number Of Medicare Beneficiaries With Drug Services | 516 |
| Total Drug Submitted ChargeAmount | 86426 |
| Total Drug Medicare AllowedAmount | 12120.32 |
| Total Drug Medicare PaymentAmount | 9439.22 |
| Total Drug Medicare Standardized Payment Amount | 9439.22 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 177 |
| Number Of Medical Services | 5415 |
| Number Of Medicare Beneficiaries With Medical Services | 3156 |
| Total Medical Submitted Charge Amount | 2978129 |
| Total Medical Medicare Allowed Amount | 762944.89 |
| Total Medical Medicare Payment Amount | 575517.95 |
| Total Medical Medicare Standardized Payment Amount | 597286.14 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 484 |
| Number Of Beneficiaries Age 65 to 74 | 1548 |
| Number Of Beneficiaries Age 75 to 84 | 834 |
| Number Of Beneficiaries Age Greater 84 | 293 |
| Number Of Female Beneficiaries | 1791 |
| Number Of Male Beneficiaries | 1368 |
| Number Of Non Hispanic White Beneficiaries | 2562 |
| Number Of Black or African American Beneficiaries | 140 |
| Number Of AsianPacific Islander Beneficiaries | 51 |
| Number Of Hispanic Beneficiaries | 320 |
| Number Of American Indian Alaska Native Beneficiaries | 40 |
| Number Of Beneficiaries With Race Not Else where Classified | 46 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2687 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 472 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 56 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5933 |