| National Provider Identifier [NPI]: | 1548271513 |
| Last Name Of The Provider | FREDETTE |
| First Name Of The Provider | STEVEN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 422 N GENERAL MCMULLEN DR |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782371572 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 3947 |
| Number Of Medicare Beneficiaries | 1037 |
| Total Submitted Charge Amount | 151271.79 |
| Total Medicare Allowed Amount | 123631.64 |
| Total Medicare Payment Amount | 90821.24 |
| Total Medicare Standardized Payment Amount | 96154.51 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 3947 |
| Number Of Medicare Beneficiaries With Medical Services | 1037 |
| Total Medical Submitted Charge Amount | 151271.79 |
| Total Medical Medicare Allowed Amount | 123631.64 |
| Total Medical Medicare Payment Amount | 90821.24 |
| Total Medical Medicare Standardized Payment Amount | 96154.51 |
| Average Age Of Beneficiaries | 83 |
| Number Of Beneficiaries Age Less65 | 51 |
| Number Of Beneficiaries Age 65 to 74 | 127 |
| Number Of Beneficiaries Age 75 to 84 | 299 |
| Number Of Beneficiaries Age Greater 84 | 560 |
| Number Of Female Beneficiaries | 717 |
| Number Of Male Beneficiaries | 320 |
| Number Of Non Hispanic White Beneficiaries | 688 |
| Number Of Black or African American Beneficiaries | 81 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 252 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 669 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 368 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 68 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 42 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 17 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 2.1335 |