| National Provider Identifier [NPI]: | 1003976564 |
| Last Name Of The Provider | CRETA |
| First Name Of The Provider | MICHAEL |
| 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 | 137 MEDICAL LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | POLLOCKSVILLE |
| Zip Code Of The Provider | 285738200 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 121 |
| Number Of Services | 3400 |
| Number Of Medicare Beneficiaries | 566 |
| Total Submitted Charge Amount | 491358.13 |
| Total Medicare Allowed Amount | 217364.44 |
| Total Medicare Payment Amount | 159228.21 |
| Total Medicare Standardized Payment Amount | 152092.66 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 162 |
| Number Of Medicare Beneficiaries With Drug Services | 121 |
| Total Drug Submitted ChargeAmount | 5051 |
| Total Drug Medicare AllowedAmount | 2127.28 |
| Total Drug Medicare PaymentAmount | 1994.69 |
| Total Drug Medicare Standardized Payment Amount | 1994.69 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 113 |
| Number Of Medical Services | 3238 |
| Number Of Medicare Beneficiaries With Medical Services | 566 |
| Total Medical Submitted Charge Amount | 486307.13 |
| Total Medical Medicare Allowed Amount | 215237.16 |
| Total Medical Medicare Payment Amount | 157233.52 |
| Total Medical Medicare Standardized Payment Amount | 150097.97 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 86 |
| Number Of Beneficiaries Age 65 to 74 | 215 |
| Number Of Beneficiaries Age 75 to 84 | 158 |
| Number Of Beneficiaries Age Greater 84 | 107 |
| Number Of Female Beneficiaries | 336 |
| Number Of Male Beneficiaries | 230 |
| Number Of Non Hispanic White Beneficiaries | 445 |
| Number Of Black or African American Beneficiaries | 90 |
| Number Of AsianPacific Islander Beneficiaries | |
| 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 | 348 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 218 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 27 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 62 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5772 |