National Provider Identifier [NPI]: |
1114979952 |
Last Name Of The Provider |
CRALL |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
4651 VAN DYKE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LUTZ |
Zip Code Of The Provider |
335584880 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
40 |
Number Of Services |
1009.5 |
Number Of Medicare Beneficiaries |
361 |
Total Submitted Charge Amount |
109443 |
Total Medicare Allowed Amount |
70350.71 |
Total Medicare Payment Amount |
46747.72 |
Total Medicare Standardized Payment Amount |
47311.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
24.5 |
Number Of Medicare Beneficiaries With Drug Services |
11 |
Total Drug Submitted ChargeAmount |
933 |
Total Drug Medicare AllowedAmount |
496.21 |
Total Drug Medicare PaymentAmount |
476.55 |
Total Drug Medicare Standardized Payment Amount |
476.55 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
985 |
Number Of Medicare Beneficiaries With Medical Services |
361 |
Total Medical Submitted Charge Amount |
108510 |
Total Medical Medicare Allowed Amount |
69854.5 |
Total Medical Medicare Payment Amount |
46271.17 |
Total Medical Medicare Standardized Payment Amount |
46834.93 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
18 |
Number Of Beneficiaries Age 65 to 74 |
161 |
Number Of Beneficiaries Age 75 to 84 |
144 |
Number Of Beneficiaries Age Greater 84 |
38 |
Number Of Female Beneficiaries |
158 |
Number Of Male Beneficiaries |
203 |
Number Of Non Hispanic White Beneficiaries |
348 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
0 |
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
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 |
13 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
9 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
3 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.8935 |