National Provider Identifier [NPI]: |
1053405548 |
Last Name Of The Provider |
KROEZE |
First Name Of The Provider |
JON |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
382 N 120TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
HOLLAND |
Zip Code Of The Provider |
49424 |
State Code Of The Provider |
MI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
788 |
Number Of Medicare Beneficiaries |
226 |
Total Submitted Charge Amount |
51074 |
Total Medicare Allowed Amount |
36199.75 |
Total Medicare Payment Amount |
26164.89 |
Total Medicare Standardized Payment Amount |
28062.72 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
126 |
Number Of Medicare Beneficiaries With Drug Services |
92 |
Total Drug Submitted ChargeAmount |
2843 |
Total Drug Medicare AllowedAmount |
2251.45 |
Total Drug Medicare PaymentAmount |
2091.26 |
Total Drug Medicare Standardized Payment Amount |
2091.26 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
662 |
Number Of Medicare Beneficiaries With Medical Services |
225 |
Total Medical Submitted Charge Amount |
48231 |
Total Medical Medicare Allowed Amount |
33948.3 |
Total Medical Medicare Payment Amount |
24073.63 |
Total Medical Medicare Standardized Payment Amount |
25971.46 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
64 |
Number Of Beneficiaries Age 65 to 74 |
81 |
Number Of Beneficiaries Age 75 to 84 |
52 |
Number Of Beneficiaries Age Greater 84 |
29 |
Number Of Female Beneficiaries |
133 |
Number Of Male Beneficiaries |
93 |
Number Of Non Hispanic White Beneficiaries |
201 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
12 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
181 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
45 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
34 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
19 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
30 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9096 |