National Provider Identifier [NPI]: |
1508807173 |
Last Name Of The Provider |
CRAWFORD |
First Name Of The Provider |
MILTON |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
DPM |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1108 S CATHERINE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
TERRELL |
Zip Code Of The Provider |
751604706 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Podiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
3 |
Number Of Services |
362 |
Number Of Medicare Beneficiaries |
177 |
Total Submitted Charge Amount |
41567.04 |
Total Medicare Allowed Amount |
41538.53 |
Total Medicare Payment Amount |
30520.68 |
Total Medicare Standardized Payment Amount |
34296.15 |
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 |
3 |
Number Of Medical Services |
362 |
Number Of Medicare Beneficiaries With Medical Services |
177 |
Total Medical Submitted Charge Amount |
41567.04 |
Total Medical Medicare Allowed Amount |
41538.53 |
Total Medical Medicare Payment Amount |
30520.68 |
Total Medical Medicare Standardized Payment Amount |
34296.15 |
Average Age Of Beneficiaries |
79 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
29 |
Number Of Beneficiaries Age 75 to 84 |
67 |
Number Of Beneficiaries Age Greater 84 |
58 |
Number Of Female Beneficiaries |
127 |
Number Of Male Beneficiaries |
50 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
119 |
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 |
97 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
80 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
39 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
60 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
2.0471 |