| National Provider Identifier [NPI]: | 1518027903 |
| Last Name Of The Provider | FREVERT |
| First Name Of The Provider | ERIC |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | PA |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3150 N 12TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRAND JUNCTION |
| Zip Code Of The Provider | 815062863 |
| State Code Of The Provider | CO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Physician Assistant |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 538 |
| Number Of Medicare Beneficiaries | 148 |
| Total Submitted Charge Amount | 43180 |
| Total Medicare Allowed Amount | 20420.56 |
| Total Medicare Payment Amount | 13609.23 |
| Total Medicare Standardized Payment Amount | 16136.76 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 40 |
| Number Of Medicare Beneficiaries With Drug Services | 12 |
| Total Drug Submitted ChargeAmount | 316 |
| Total Drug Medicare AllowedAmount | 130.93 |
| Total Drug Medicare PaymentAmount | 115.83 |
| Total Drug Medicare Standardized Payment Amount | 115.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 67 |
| Number Of Medical Services | 498 |
| Number Of Medicare Beneficiaries With Medical Services | 148 |
| Total Medical Submitted Charge Amount | 42864 |
| Total Medical Medicare Allowed Amount | 20289.63 |
| Total Medical Medicare Payment Amount | 13493.4 |
| Total Medical Medicare Standardized Payment Amount | 16020.93 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 69 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 99 |
| Number Of Male Beneficiaries | 49 |
| Number Of Non Hispanic White Beneficiaries | 130 |
| 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 | 119 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 29 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | 10 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 24 |
| Percent Of With Hypertension | 44 |
| Percent Of With Ischemic Heart Disease | 9 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8271 |