| National Provider Identifier [NPI]: | 1053428045 |
| Last Name Of The Provider | FRECKLETON |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7909 FREDERICKSBURG RD |
| Street Address 2 Of The Provider | SUITE #127 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782293425 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 8537 |
| Number Of Medicare Beneficiaries | 1168 |
| Total Submitted Charge Amount | 336355 |
| Total Medicare Allowed Amount | 133509.77 |
| Total Medicare Payment Amount | 100237.63 |
| Total Medicare Standardized Payment Amount | 107582 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 7170 |
| Number Of Medicare Beneficiaries With Drug Services | 70 |
| Total Drug Submitted ChargeAmount | 8010 |
| Total Drug Medicare AllowedAmount | 1612.62 |
| Total Drug Medicare PaymentAmount | 1250.84 |
| Total Drug Medicare Standardized Payment Amount | 1250.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 1367 |
| Number Of Medicare Beneficiaries With Medical Services | 1168 |
| Total Medical Submitted Charge Amount | 328345 |
| Total Medical Medicare Allowed Amount | 131897.15 |
| Total Medical Medicare Payment Amount | 98986.79 |
| Total Medical Medicare Standardized Payment Amount | 106331.16 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 325 |
| Number Of Beneficiaries Age 65 to 74 | 499 |
| Number Of Beneficiaries Age 75 to 84 | 265 |
| Number Of Beneficiaries Age Greater 84 | 79 |
| Number Of Female Beneficiaries | 564 |
| Number Of Male Beneficiaries | 604 |
| Number Of Non Hispanic White Beneficiaries | 601 |
| Number Of Black or African American Beneficiaries | 71 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| Number Of Hispanic Beneficiaries | 470 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 821 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 347 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 52 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 15 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.9167 |