| National Provider Identifier [NPI]: | 1467441691 |
| Last Name Of The Provider | FREY |
| First Name Of The Provider | ROGER |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 18 SQUADRON BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEW CITY |
| Zip Code Of The Provider | 109565210 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 182 |
| Number Of Services | 5654 |
| Number Of Medicare Beneficiaries | 2444 |
| Total Submitted Charge Amount | 523028.3 |
| Total Medicare Allowed Amount | 160284.32 |
| Total Medicare Payment Amount | 123738.51 |
| Total Medicare Standardized Payment Amount | 110745.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 941 |
| Number Of Medicare Beneficiaries With Drug Services | 11 |
| Total Drug Submitted ChargeAmount | 282.3 |
| Total Drug Medicare AllowedAmount | 168.39 |
| Total Drug Medicare PaymentAmount | 132.02 |
| Total Drug Medicare Standardized Payment Amount | 132.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 181 |
| Number Of Medical Services | 4713 |
| Number Of Medicare Beneficiaries With Medical Services | 2444 |
| Total Medical Submitted Charge Amount | 522746 |
| Total Medical Medicare Allowed Amount | 160115.93 |
| Total Medical Medicare Payment Amount | 123606.49 |
| Total Medical Medicare Standardized Payment Amount | 110613.02 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 331 |
| Number Of Beneficiaries Age 65 to 74 | 653 |
| Number Of Beneficiaries Age 75 to 84 | 791 |
| Number Of Beneficiaries Age Greater 84 | 669 |
| Number Of Female Beneficiaries | 1506 |
| Number Of Male Beneficiaries | 938 |
| Number Of Non Hispanic White Beneficiaries | 1897 |
| Number Of Black or African American Beneficiaries | 276 |
| Number Of AsianPacific Islander Beneficiaries | 58 |
| Number Of Hispanic Beneficiaries | 172 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 41 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1619 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 825 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 29 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.0335 |