National Provider Identifier [NPI]: |
1619912540 |
Last Name Of The Provider |
KROEZE |
First Name Of The Provider |
BOYD |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
602 MICHIGAN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOLLAND |
Zip Code Of The Provider |
494234918 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
682 |
Number Of Medicare Beneficiaries |
437 |
Total Submitted Charge Amount |
193821 |
Total Medicare Allowed Amount |
61136.73 |
Total Medicare Payment Amount |
44122.82 |
Total Medicare Standardized Payment Amount |
45192.7 |
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 |
22 |
Number Of Medical Services |
682 |
Number Of Medicare Beneficiaries With Medical Services |
437 |
Total Medical Submitted Charge Amount |
193821 |
Total Medical Medicare Allowed Amount |
61136.73 |
Total Medical Medicare Payment Amount |
44122.82 |
Total Medical Medicare Standardized Payment Amount |
45192.7 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
164 |
Number Of Beneficiaries Age 65 to 74 |
108 |
Number Of Beneficiaries Age 75 to 84 |
72 |
Number Of Beneficiaries Age Greater 84 |
93 |
Number Of Female Beneficiaries |
264 |
Number Of Male Beneficiaries |
173 |
Number Of Non Hispanic White Beneficiaries |
362 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
45 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
237 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
200 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
23 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
29 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
19 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9227 |