National Provider Identifier [NPI]: |
1932239100 |
Last Name Of The Provider |
KREMER |
First Name Of The Provider |
GLENDA |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
909 9TH AVE |
Street Address 2 Of The Provider |
SUITE 300 |
City Of The Provider |
FORT WORTH |
Zip Code Of The Provider |
761043903 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
85 |
Number Of Services |
4085 |
Number Of Medicare Beneficiaries |
247 |
Total Submitted Charge Amount |
247947.69 |
Total Medicare Allowed Amount |
132443.54 |
Total Medicare Payment Amount |
104491 |
Total Medicare Standardized Payment Amount |
106864.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
392 |
Number Of Medicare Beneficiaries With Drug Services |
80 |
Total Drug Submitted ChargeAmount |
16755 |
Total Drug Medicare AllowedAmount |
9449.96 |
Total Drug Medicare PaymentAmount |
8363.76 |
Total Drug Medicare Standardized Payment Amount |
8363.76 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
74 |
Number Of Medical Services |
3693 |
Number Of Medicare Beneficiaries With Medical Services |
247 |
Total Medical Submitted Charge Amount |
231192.69 |
Total Medical Medicare Allowed Amount |
122993.58 |
Total Medical Medicare Payment Amount |
96127.24 |
Total Medical Medicare Standardized Payment Amount |
98500.6 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
62 |
Number Of Beneficiaries Age Greater 84 |
26 |
Number Of Female Beneficiaries |
187 |
Number Of Male Beneficiaries |
60 |
Number Of Non Hispanic White Beneficiaries |
162 |
Number Of Black or African American Beneficiaries |
66 |
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 |
222 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
25 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
7 |
Average HCC Risk Score Of Beneficiaries |
1.1238 |