National Provider Identifier [NPI]: |
1427081355 |
Last Name Of The Provider |
CRUM |
First Name Of The Provider |
FREDERICK |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3235 ACADEMY AVE |
Street Address 2 Of The Provider |
SUITE 102 |
City Of The Provider |
PORTSMOUTH |
Zip Code Of The Provider |
237033200 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
37 |
Number Of Services |
2614 |
Number Of Medicare Beneficiaries |
377 |
Total Submitted Charge Amount |
221160 |
Total Medicare Allowed Amount |
174968.08 |
Total Medicare Payment Amount |
120555.06 |
Total Medicare Standardized Payment Amount |
125399.89 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
265 |
Number Of Medicare Beneficiaries With Drug Services |
244 |
Total Drug Submitted ChargeAmount |
10436 |
Total Drug Medicare AllowedAmount |
8708.43 |
Total Drug Medicare PaymentAmount |
8504.84 |
Total Drug Medicare Standardized Payment Amount |
8504.84 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
31 |
Number Of Medical Services |
2349 |
Number Of Medicare Beneficiaries With Medical Services |
377 |
Total Medical Submitted Charge Amount |
210724 |
Total Medical Medicare Allowed Amount |
166259.65 |
Total Medical Medicare Payment Amount |
112050.22 |
Total Medical Medicare Standardized Payment Amount |
116895.05 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
163 |
Number Of Beneficiaries Age 75 to 84 |
134 |
Number Of Beneficiaries Age Greater 84 |
60 |
Number Of Female Beneficiaries |
195 |
Number Of Male Beneficiaries |
182 |
Number Of Non Hispanic White Beneficiaries |
282 |
Number Of Black or African American Beneficiaries |
84 |
Number Of AsianPacific Islander Beneficiaries |
|
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 |
363 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
14 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
12 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
1.1216 |