National Provider Identifier [NPI]: |
1497757454 |
Last Name Of The Provider |
CROWL |
First Name Of The Provider |
LORI |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
107 ROYAL BIRKDALE DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLUMBIANA |
Zip Code Of The Provider |
444088493 |
State Code Of The Provider |
OH |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
79 |
Number Of Services |
2020 |
Number Of Medicare Beneficiaries |
346 |
Total Submitted Charge Amount |
135714 |
Total Medicare Allowed Amount |
107153.62 |
Total Medicare Payment Amount |
74929.67 |
Total Medicare Standardized Payment Amount |
78410 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
9 |
Number Of Drug Services |
380 |
Number Of Medicare Beneficiaries With Drug Services |
144 |
Total Drug Submitted ChargeAmount |
5912 |
Total Drug Medicare AllowedAmount |
3641.85 |
Total Drug Medicare PaymentAmount |
3311.56 |
Total Drug Medicare Standardized Payment Amount |
3311.56 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
70 |
Number Of Medical Services |
1640 |
Number Of Medicare Beneficiaries With Medical Services |
346 |
Total Medical Submitted Charge Amount |
129802 |
Total Medical Medicare Allowed Amount |
103511.77 |
Total Medical Medicare Payment Amount |
71618.11 |
Total Medical Medicare Standardized Payment Amount |
75098.44 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
154 |
Number Of Beneficiaries Age 75 to 84 |
107 |
Number Of Beneficiaries Age Greater 84 |
48 |
Number Of Female Beneficiaries |
243 |
Number Of Male Beneficiaries |
103 |
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 |
314 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.0118 |