| National Provider Identifier [NPI]: | 1982731311 |
| Last Name Of The Provider | CROUTCH |
| First Name Of The Provider | KENNETH |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8700 BEVERLY BLVD |
| Street Address 2 Of The Provider | ROOM M335 |
| City Of The Provider | LOS ANGELES |
| Zip Code Of The Provider | 90048 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 157 |
| Number Of Services | 4172 |
| Number Of Medicare Beneficiaries | 2848 |
| Total Submitted Charge Amount | 1056019.28 |
| Total Medicare Allowed Amount | 161741.18 |
| Total Medicare Payment Amount | 127145.7 |
| Total Medicare Standardized Payment Amount | 121504.53 |
| 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 | 157 |
| Number Of Medical Services | 4172 |
| Number Of Medicare Beneficiaries With Medical Services | 2848 |
| Total Medical Submitted Charge Amount | 1056019.28 |
| Total Medical Medicare Allowed Amount | 161741.18 |
| Total Medical Medicare Payment Amount | 127145.7 |
| Total Medical Medicare Standardized Payment Amount | 121504.53 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 348 |
| Number Of Beneficiaries Age 65 to 74 | 1036 |
| Number Of Beneficiaries Age 75 to 84 | 856 |
| Number Of Beneficiaries Age Greater 84 | 608 |
| Number Of Female Beneficiaries | 1537 |
| Number Of Male Beneficiaries | 1311 |
| Number Of Non Hispanic White Beneficiaries | 1918 |
| Number Of Black or African American Beneficiaries | 375 |
| Number Of AsianPacific Islander Beneficiaries | 211 |
| Number Of Hispanic Beneficiaries | 250 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1816 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1032 |
| Percent Of With Atrial Fibrillation | 24 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.4611 |