| National Provider Identifier [NPI]: | 1124030499 |
| Last Name Of The Provider | KROLL |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4070 EQUESTRIAN LN |
| Street Address 2 Of The Provider | |
| City Of The Provider | GREEN BAY |
| Zip Code Of The Provider | 542299649 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 60 |
| Number Of Services | 1278 |
| Number Of Medicare Beneficiaries | 213 |
| Total Submitted Charge Amount | 196236.45 |
| Total Medicare Allowed Amount | 62733.05 |
| Total Medicare Payment Amount | 47287.34 |
| Total Medicare Standardized Payment Amount | 50212.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 101 |
| Number Of Medicare Beneficiaries With Drug Services | 84 |
| Total Drug Submitted ChargeAmount | 4248.45 |
| Total Drug Medicare AllowedAmount | 2471.51 |
| Total Drug Medicare PaymentAmount | 2371.49 |
| Total Drug Medicare Standardized Payment Amount | 2371.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 50 |
| Number Of Medical Services | 1177 |
| Number Of Medicare Beneficiaries With Medical Services | 213 |
| Total Medical Submitted Charge Amount | 191988 |
| Total Medical Medicare Allowed Amount | 60261.54 |
| Total Medical Medicare Payment Amount | 44915.85 |
| Total Medical Medicare Standardized Payment Amount | 47841.38 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 108 |
| Number Of Beneficiaries Age 75 to 84 | 59 |
| Number Of Beneficiaries Age Greater 84 | 24 |
| Number Of Female Beneficiaries | 87 |
| Number Of Male Beneficiaries | 126 |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 0.9969 |