| National Provider Identifier [NPI]: | 1881633568 |
| Last Name Of The Provider | CRESPO |
| First Name Of The Provider | JORGE |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 745A ROUTE 63 |
| Street Address 2 Of The Provider | |
| City Of The Provider | CHESTERFIELD |
| Zip Code Of The Provider | 034433604 |
| State Code Of The Provider | NH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Dermatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 56 |
| Number Of Services | 5257 |
| Number Of Medicare Beneficiaries | 1391 |
| Total Submitted Charge Amount | 889037.21 |
| Total Medicare Allowed Amount | 453426.99 |
| Total Medicare Payment Amount | 327036.73 |
| Total Medicare Standardized Payment Amount | 305154.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 27 |
| Number Of Medicare Beneficiaries With Drug Services | 20 |
| Total Drug Submitted ChargeAmount | 1056 |
| Total Drug Medicare AllowedAmount | 862.45 |
| Total Drug Medicare PaymentAmount | 676.19 |
| Total Drug Medicare Standardized Payment Amount | 676.19 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 54 |
| Number Of Medical Services | 5230 |
| Number Of Medicare Beneficiaries With Medical Services | 1391 |
| Total Medical Submitted Charge Amount | 887981.21 |
| Total Medical Medicare Allowed Amount | 452564.54 |
| Total Medical Medicare Payment Amount | 326360.54 |
| Total Medical Medicare Standardized Payment Amount | 304478.31 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 642 |
| Number Of Beneficiaries Age 75 to 84 | 485 |
| Number Of Beneficiaries Age Greater 84 | 243 |
| Number Of Female Beneficiaries | 761 |
| Number Of Male Beneficiaries | 630 |
| Number Of Non Hispanic White Beneficiaries | 1340 |
| 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 | 1347 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 44 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 6 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 43 |
| Percent Of With Ischemic Heart Disease | 20 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.8114 |