National Provider Identifier [NPI]: |
1326150285 |
Last Name Of The Provider |
GREWELL |
First Name Of The Provider |
DONALD |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
DO |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2675 CENTRAL AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
BILLINGS |
Zip Code Of The Provider |
591026686 |
State Code Of The Provider |
MT |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
533 |
Number Of Medicare Beneficiaries |
270 |
Total Submitted Charge Amount |
35284 |
Total Medicare Allowed Amount |
31024.53 |
Total Medicare Payment Amount |
19931.12 |
Total Medicare Standardized Payment Amount |
19789.45 |
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 |
20 |
Number Of Medical Services |
533 |
Number Of Medicare Beneficiaries With Medical Services |
270 |
Total Medical Submitted Charge Amount |
35284 |
Total Medical Medicare Allowed Amount |
31024.53 |
Total Medical Medicare Payment Amount |
19931.12 |
Total Medical Medicare Standardized Payment Amount |
19789.45 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
132 |
Number Of Beneficiaries Age 75 to 84 |
57 |
Number Of Beneficiaries Age Greater 84 |
34 |
Number Of Female Beneficiaries |
132 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
254 |
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 |
220 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
50 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
|
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
40 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9523 |