| National Provider Identifier [NPI]: | 1609849140 |
| Last Name Of The Provider | CRISOSTOMO |
| First Name Of The Provider | ARTHUR |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | N57W24950 N CORPORATE CIR |
| Street Address 2 Of The Provider | PROHEALTH CARE MEDICAL ASSOCIATES INC. |
| City Of The Provider | SUSSEX |
| Zip Code Of The Provider | 530894383 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 28 |
| Number Of Services | 1945 |
| Number Of Medicare Beneficiaries | 310 |
| Total Submitted Charge Amount | 245007 |
| Total Medicare Allowed Amount | 101713.27 |
| Total Medicare Payment Amount | 75459.23 |
| Total Medicare Standardized Payment Amount | 77615.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 1138 |
| Number Of Medicare Beneficiaries With Drug Services | 21 |
| Total Drug Submitted ChargeAmount | 39756 |
| Total Drug Medicare AllowedAmount | 28910.58 |
| Total Drug Medicare PaymentAmount | 22633.73 |
| Total Drug Medicare Standardized Payment Amount | 22633.73 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 22 |
| Number Of Medical Services | 807 |
| Number Of Medicare Beneficiaries With Medical Services | 310 |
| Total Medical Submitted Charge Amount | 205251 |
| Total Medical Medicare Allowed Amount | 72802.69 |
| Total Medical Medicare Payment Amount | 52825.5 |
| Total Medical Medicare Standardized Payment Amount | 54981.52 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 167 |
| Number Of Beneficiaries Age 75 to 84 | 78 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 134 |
| Number Of Male Beneficiaries | 176 |
| Number Of Non Hispanic White Beneficiaries | 294 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| 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 | 276 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 34 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.3469 |