| National Provider Identifier [NPI]: | 1154360923 |
| Last Name Of The Provider | FREEMYER |
| First Name Of The Provider | VINCENT |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | DO |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 111 DALLAS ST |
| Street Address 2 Of The Provider | ATTN: EMERGENCY ROOM |
| City Of The Provider | SAN ANTONIO |
| Zip Code Of The Provider | 782051201 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 32 |
| Number Of Services | 928 |
| Number Of Medicare Beneficiaries | 806 |
| Total Submitted Charge Amount | 540577.75 |
| Total Medicare Allowed Amount | 137518.43 |
| Total Medicare Payment Amount | 101650.59 |
| Total Medicare Standardized Payment Amount | 104752.69 |
| 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 | 32 |
| Number Of Medical Services | 928 |
| Number Of Medicare Beneficiaries With Medical Services | 806 |
| Total Medical Submitted Charge Amount | 540577.75 |
| Total Medical Medicare Allowed Amount | 137518.43 |
| Total Medical Medicare Payment Amount | 101650.59 |
| Total Medical Medicare Standardized Payment Amount | 104752.69 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 258 |
| Number Of Beneficiaries Age 65 to 74 | 226 |
| Number Of Beneficiaries Age 75 to 84 | 193 |
| Number Of Beneficiaries Age Greater 84 | 129 |
| Number Of Female Beneficiaries | 470 |
| Number Of Male Beneficiaries | 336 |
| Number Of Non Hispanic White Beneficiaries | 540 |
| Number Of Black or African American Beneficiaries | 172 |
| 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 | 461 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 345 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 13 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.003 |