| National Provider Identifier [NPI]: | 1366497174 |
| Last Name Of The Provider | CROCKER |
| First Name Of The Provider | NORMAN |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1387 S HAMETOWN RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | COPLEY |
| Zip Code Of The Provider | 443211831 |
| State Code Of The Provider | OH |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 205 |
| Number Of Services | 6760 |
| Number Of Medicare Beneficiaries | 2615 |
| Total Submitted Charge Amount | 501420.5 |
| Total Medicare Allowed Amount | 193261.51 |
| Total Medicare Payment Amount | 148351.01 |
| Total Medicare Standardized Payment Amount | 153197.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 205 |
| Number Of Medical Services | 6760 |
| Number Of Medicare Beneficiaries With Medical Services | 2615 |
| Total Medical Submitted Charge Amount | 501420.5 |
| Total Medical Medicare Allowed Amount | 193261.51 |
| Total Medical Medicare Payment Amount | 148351.01 |
| Total Medical Medicare Standardized Payment Amount | 153197.3 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 461 |
| Number Of Beneficiaries Age 65 to 74 | 958 |
| Number Of Beneficiaries Age 75 to 84 | 743 |
| Number Of Beneficiaries Age Greater 84 | 453 |
| Number Of Female Beneficiaries | 1674 |
| Number Of Male Beneficiaries | 941 |
| Number Of Non Hispanic White Beneficiaries | 2524 |
| Number Of Black or African American Beneficiaries | 40 |
| 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 | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2006 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 609 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4752 |