| National Provider Identifier [NPI]: | 1487656393 |
| Last Name Of The Provider | FREDERICK |
| First Name Of The Provider | RANDALL |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8000 WOLF RIVER BLVD |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | GERMANTOWN |
| Zip Code Of The Provider | 381381727 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Gastroenterology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 77 |
| Number Of Services | 2747 |
| Number Of Medicare Beneficiaries | 733 |
| Total Submitted Charge Amount | 626809 |
| Total Medicare Allowed Amount | 190304.79 |
| Total Medicare Payment Amount | 145067.45 |
| Total Medicare Standardized Payment Amount | 157454.6 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 859 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 33632 |
| Total Drug Medicare AllowedAmount | 20730.5 |
| Total Drug Medicare PaymentAmount | 16264.42 |
| Total Drug Medicare Standardized Payment Amount | 16264.42 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 69 |
| Number Of Medical Services | 1888 |
| Number Of Medicare Beneficiaries With Medical Services | 733 |
| Total Medical Submitted Charge Amount | 593177 |
| Total Medical Medicare Allowed Amount | 169574.29 |
| Total Medical Medicare Payment Amount | 128803.03 |
| Total Medical Medicare Standardized Payment Amount | 141190.18 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 93 |
| Number Of Beneficiaries Age 65 to 74 | 328 |
| Number Of Beneficiaries Age 75 to 84 | 230 |
| Number Of Beneficiaries Age Greater 84 | 82 |
| Number Of Female Beneficiaries | 431 |
| Number Of Male Beneficiaries | 302 |
| Number Of Non Hispanic White Beneficiaries | 600 |
| Number Of Black or African American Beneficiaries | 120 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 594 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 139 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.782 |