National Provider Identifier [NPI]: |
1649434036 |
Last Name Of The Provider |
FRIEDRICH |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
D.P.M. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
400 S KENNEDY DR |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
BRADLEY |
Zip Code Of The Provider |
609152682 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
89 |
Number Of Services |
2025 |
Number Of Medicare Beneficiaries |
463 |
Total Submitted Charge Amount |
435368 |
Total Medicare Allowed Amount |
136795.64 |
Total Medicare Payment Amount |
102084.19 |
Total Medicare Standardized Payment Amount |
106063.52 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
122 |
Number Of Medicare Beneficiaries With Drug Services |
37 |
Total Drug Submitted ChargeAmount |
2440 |
Total Drug Medicare AllowedAmount |
216.68 |
Total Drug Medicare PaymentAmount |
169.79 |
Total Drug Medicare Standardized Payment Amount |
169.79 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
88 |
Number Of Medical Services |
1903 |
Number Of Medicare Beneficiaries With Medical Services |
463 |
Total Medical Submitted Charge Amount |
432928 |
Total Medical Medicare Allowed Amount |
136578.96 |
Total Medical Medicare Payment Amount |
101914.4 |
Total Medical Medicare Standardized Payment Amount |
105893.73 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
75 |
Number Of Beneficiaries Age 65 to 74 |
180 |
Number Of Beneficiaries Age 75 to 84 |
135 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
273 |
Number Of Male Beneficiaries |
190 |
Number Of Non Hispanic White Beneficiaries |
423 |
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
310 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
153 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
36 |
Percent Of With Chronic Obstructive Pulmonary Disease |
24 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
57 |
Percent Of With Schizophrenia Other PsychoticDisorders |
9 |
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.7132 |