National Provider Identifier [NPI]: |
1750383105 |
Last Name Of The Provider |
CRANDALL |
First Name Of The Provider |
ROBERT |
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 |
74720 G RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
OVERTON |
Zip Code Of The Provider |
688635811 |
State Code Of The Provider |
NE |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
608 |
Number Of Medicare Beneficiaries |
527 |
Total Submitted Charge Amount |
191182 |
Total Medicare Allowed Amount |
87527.14 |
Total Medicare Payment Amount |
64914.65 |
Total Medicare Standardized Payment Amount |
69204.6 |
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 |
608 |
Number Of Medicare Beneficiaries With Medical Services |
527 |
Total Medical Submitted Charge Amount |
191182 |
Total Medical Medicare Allowed Amount |
87527.14 |
Total Medical Medicare Payment Amount |
64914.65 |
Total Medical Medicare Standardized Payment Amount |
69204.6 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
99 |
Number Of Beneficiaries Age 65 to 74 |
153 |
Number Of Beneficiaries Age 75 to 84 |
148 |
Number Of Beneficiaries Age Greater 84 |
127 |
Number Of Female Beneficiaries |
286 |
Number Of Male Beneficiaries |
241 |
Number Of Non Hispanic White Beneficiaries |
494 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
383 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
144 |
Percent Of With Atrial Fibrillation |
28 |
Percent Of With Alzheimers Disease or Dementia |
20 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
38 |
Percent Of With Chronic Obstructive Pulmonary Disease |
29 |
Percent Of With Depression |
37 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
18 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.7556 |