| National Provider Identifier [NPI]: | 1730138843 |
| Last Name Of The Provider | FREDERICKS |
| First Name Of The Provider | RUTH |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 971 LAKELAND DR |
| Street Address 2 Of The Provider | SUITE 557 |
| City Of The Provider | JACKSON |
| Zip Code Of The Provider | 392164643 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 53414 |
| Number Of Medicare Beneficiaries | 2349 |
| Total Submitted Charge Amount | 3367583.78 |
| Total Medicare Allowed Amount | 1345955.37 |
| Total Medicare Payment Amount | 1000540.86 |
| Total Medicare Standardized Payment Amount | 1035407.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 46972 |
| Number Of Medicare Beneficiaries With Drug Services | 87 |
| Total Drug Submitted ChargeAmount | 2622816.28 |
| Total Drug Medicare AllowedAmount | 878880.1 |
| Total Drug Medicare PaymentAmount | 671861.81 |
| Total Drug Medicare Standardized Payment Amount | 671861.81 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 39 |
| Number Of Medical Services | 6442 |
| Number Of Medicare Beneficiaries With Medical Services | 2348 |
| Total Medical Submitted Charge Amount | 744767.5 |
| Total Medical Medicare Allowed Amount | 467075.27 |
| Total Medical Medicare Payment Amount | 328679.05 |
| Total Medical Medicare Standardized Payment Amount | 363545.95 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 600 |
| Number Of Beneficiaries Age 65 to 74 | 896 |
| Number Of Beneficiaries Age 75 to 84 | 639 |
| Number Of Beneficiaries Age Greater 84 | 214 |
| Number Of Female Beneficiaries | 1557 |
| Number Of Male Beneficiaries | 792 |
| Number Of Non Hispanic White Beneficiaries | 1990 |
| Number Of Black or African American Beneficiaries | 326 |
| 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 | 17 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1941 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 408 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 21 |
| Average HCC Risk Score Of Beneficiaries | 1.3228 |