National Provider Identifier [NPI]: |
1083651368 |
Last Name Of The Provider |
CROSWELL |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
30 CHASE AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WATERVILLE |
Zip Code Of The Provider |
049014624 |
State Code Of The Provider |
ME |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Psychiatry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
25 |
Number Of Services |
2000 |
Number Of Medicare Beneficiaries |
347 |
Total Submitted Charge Amount |
215157 |
Total Medicare Allowed Amount |
119134.29 |
Total Medicare Payment Amount |
88534.02 |
Total Medicare Standardized Payment Amount |
98697.69 |
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 |
25 |
Number Of Medical Services |
2000 |
Number Of Medicare Beneficiaries With Medical Services |
347 |
Total Medical Submitted Charge Amount |
215157 |
Total Medical Medicare Allowed Amount |
119134.29 |
Total Medical Medicare Payment Amount |
88534.02 |
Total Medical Medicare Standardized Payment Amount |
98697.69 |
Average Age Of Beneficiaries |
58 |
Number Of Beneficiaries Age Less65 |
224 |
Number Of Beneficiaries Age 65 to 74 |
73 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
201 |
Number Of Male Beneficiaries |
146 |
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 |
75 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
272 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
16 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
75 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
50 |
Percent Of With Ischemic Heart Disease |
20 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
44 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.3805 |