| National Provider Identifier [NPI]: | 1558584235 |
| Last Name Of The Provider | FRECH |
| First Name Of The Provider | PETER |
| Middle Initial Of The Provider | H |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 915 HIGHLAND BLVD |
| Street Address 2 Of The Provider | STE 4100 |
| City Of The Provider | BOZEMAN |
| Zip Code Of The Provider | 597146905 |
| State Code Of The Provider | MT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 170 |
| Number Of Services | 10407 |
| Number Of Medicare Beneficiaries | 1625 |
| Total Submitted Charge Amount | 886966.82 |
| Total Medicare Allowed Amount | 160104.17 |
| Total Medicare Payment Amount | 124400.98 |
| Total Medicare Standardized Payment Amount | 124851.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 7752 |
| Number Of Medicare Beneficiaries With Drug Services | 90 |
| Total Drug Submitted ChargeAmount | 18356.66 |
| Total Drug Medicare AllowedAmount | 2559.02 |
| Total Drug Medicare PaymentAmount | 1990.99 |
| Total Drug Medicare Standardized Payment Amount | 1990.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 167 |
| Number Of Medical Services | 2655 |
| Number Of Medicare Beneficiaries With Medical Services | 1625 |
| Total Medical Submitted Charge Amount | 868610.16 |
| Total Medical Medicare Allowed Amount | 157545.15 |
| Total Medical Medicare Payment Amount | 122409.99 |
| Total Medical Medicare Standardized Payment Amount | 122860.61 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 184 |
| Number Of Beneficiaries Age 65 to 74 | 735 |
| Number Of Beneficiaries Age 75 to 84 | 487 |
| Number Of Beneficiaries Age Greater 84 | 219 |
| Number Of Female Beneficiaries | 1050 |
| Number Of Male Beneficiaries | 575 |
| Number Of Non Hispanic White Beneficiaries | 1564 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 17 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1426 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 199 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 20 |
| Percent Of With Hyperlipidemia | 31 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 23 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.0618 |