| National Provider Identifier [NPI]: | 1316994783 |
| Last Name Of The Provider | CRENSHAW |
| First Name Of The Provider | NEVILLE |
| Middle Initial Of The Provider | Q |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 133 E MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | KAHOKA |
| Zip Code Of The Provider | 634451775 |
| State Code Of The Provider | MO |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 98 |
| Number Of Services | 8533.5 |
| Number Of Medicare Beneficiaries | 305 |
| Total Submitted Charge Amount | 689163 |
| Total Medicare Allowed Amount | 391630.16 |
| Total Medicare Payment Amount | 289063.26 |
| Total Medicare Standardized Payment Amount | 311564.82 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 387.5 |
| Number Of Medicare Beneficiaries With Drug Services | 177 |
| Total Drug Submitted ChargeAmount | 8009 |
| Total Drug Medicare AllowedAmount | 2374.68 |
| Total Drug Medicare PaymentAmount | 1922.23 |
| Total Drug Medicare Standardized Payment Amount | 1922.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 94 |
| Number Of Medical Services | 8146 |
| Number Of Medicare Beneficiaries With Medical Services | 305 |
| Total Medical Submitted Charge Amount | 681154 |
| Total Medical Medicare Allowed Amount | 389255.48 |
| Total Medical Medicare Payment Amount | 287141.03 |
| Total Medical Medicare Standardized Payment Amount | 309642.59 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 36 |
| Number Of Beneficiaries Age 65 to 74 | 137 |
| Number Of Beneficiaries Age 75 to 84 | 91 |
| Number Of Beneficiaries Age Greater 84 | 41 |
| Number Of Female Beneficiaries | 169 |
| Number Of Male Beneficiaries | 136 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | 242 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 63 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 12 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 50 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 62 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 67 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.673 |