National Provider Identifier [NPI]: |
1700835006 |
Last Name Of The Provider |
KRUEGER |
First Name Of The Provider |
CORY |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
305 S WILLARD ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
COTTONWOOD |
Zip Code Of The Provider |
863264127 |
State Code Of The Provider |
AZ |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
4807 |
Number Of Medicare Beneficiaries |
626 |
Total Submitted Charge Amount |
317436.21 |
Total Medicare Allowed Amount |
260717.85 |
Total Medicare Payment Amount |
187837.34 |
Total Medicare Standardized Payment Amount |
194880.75 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
1814 |
Number Of Medicare Beneficiaries With Drug Services |
313 |
Total Drug Submitted ChargeAmount |
45044.8 |
Total Drug Medicare AllowedAmount |
33168.33 |
Total Drug Medicare PaymentAmount |
28225.16 |
Total Drug Medicare Standardized Payment Amount |
28225.16 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
2993 |
Number Of Medicare Beneficiaries With Medical Services |
626 |
Total Medical Submitted Charge Amount |
272391.41 |
Total Medical Medicare Allowed Amount |
227549.52 |
Total Medical Medicare Payment Amount |
159612.18 |
Total Medical Medicare Standardized Payment Amount |
166655.59 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
248 |
Number Of Beneficiaries Age 75 to 84 |
231 |
Number Of Beneficiaries Age Greater 84 |
124 |
Number Of Female Beneficiaries |
356 |
Number Of Male Beneficiaries |
270 |
Number Of Non Hispanic White Beneficiaries |
592 |
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 |
585 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
21 |
Percent Of With Diabetes |
22 |
Percent Of With Hyperlipidemia |
39 |
Percent Of With Hypertension |
54 |
Percent Of With Ischemic Heart Disease |
22 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0091 |