| National Provider Identifier [NPI]: | 1659504264 |
| Last Name Of The Provider | FREEMAN |
| First Name Of The Provider | WANDA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | FNP-BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 13901 E JEFFERSON AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DETROIT |
| Zip Code Of The Provider | 482152720 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 13 |
| Number Of Services | 91 |
| Number Of Medicare Beneficiaries | 47 |
| Total Submitted Charge Amount | 3471.62 |
| Total Medicare Allowed Amount | 3164.08 |
| Total Medicare Payment Amount | 2865.76 |
| Total Medicare Standardized Payment Amount | 3128.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 38 |
| Number Of Medicare Beneficiaries With Drug Services | 34 |
| Total Drug Submitted ChargeAmount | 1428.62 |
| Total Drug Medicare AllowedAmount | 1310.06 |
| Total Drug Medicare PaymentAmount | 1253.49 |
| Total Drug Medicare Standardized Payment Amount | 1253.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 8 |
| Number Of Medical Services | 53 |
| Number Of Medicare Beneficiaries With Medical Services | 46 |
| Total Medical Submitted Charge Amount | 2043 |
| Total Medical Medicare Allowed Amount | 1854.02 |
| Total Medical Medicare Payment Amount | 1612.27 |
| Total Medical Medicare Standardized Payment Amount | 1875.33 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 19 |
| Number Of Beneficiaries Age 75 to 84 | 16 |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | |
| Number Of Male Beneficiaries | |
| Number Of Non Hispanic White Beneficiaries | 36 |
| Number Of Black or African American Beneficiaries | 11 |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | 0 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 0 |
| Number Of Beneficiaries With Medicare Only Entitlement | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 51 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.9661 |