| National Provider Identifier [NPI]: | 1710957048 |
| Last Name Of The Provider | FEDRO |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 688 ALLIANCE PKWY |
| Street Address 2 Of The Provider | SUITE #201 |
| City Of The Provider | HEWITT |
| Zip Code Of The Provider | 766433585 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 2402 |
| Number Of Medicare Beneficiaries | 441 |
| Total Submitted Charge Amount | 681691.09 |
| Total Medicare Allowed Amount | 257239.96 |
| Total Medicare Payment Amount | 185284.84 |
| Total Medicare Standardized Payment Amount | 197286.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 71 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 1909.09 |
| Total Drug Medicare AllowedAmount | 580.45 |
| Total Drug Medicare PaymentAmount | 554.24 |
| Total Drug Medicare Standardized Payment Amount | 554.24 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 23 |
| Number Of Medical Services | 2331 |
| Number Of Medicare Beneficiaries With Medical Services | 441 |
| Total Medical Submitted Charge Amount | 679782 |
| Total Medical Medicare Allowed Amount | 256659.51 |
| Total Medical Medicare Payment Amount | 184730.6 |
| Total Medical Medicare Standardized Payment Amount | 196732.4 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 91 |
| Number Of Beneficiaries Age 65 to 74 | 116 |
| Number Of Beneficiaries Age 75 to 84 | 104 |
| Number Of Beneficiaries Age Greater 84 | 130 |
| Number Of Female Beneficiaries | 280 |
| Number Of Male Beneficiaries | 161 |
| Number Of Non Hispanic White Beneficiaries | 331 |
| Number Of Black or African American Beneficiaries | 77 |
| 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 | 265 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 176 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 35 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 12 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5083 |