National Provider Identifier [NPI]: |
1689803579 |
Last Name Of The Provider |
CROSBY |
First Name Of The Provider |
MARCUS |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1836 SOUTH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
LA CROSSE |
Zip Code Of The Provider |
546015429 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
284 |
Number Of Medicare Beneficiaries |
151 |
Total Submitted Charge Amount |
94311.75 |
Total Medicare Allowed Amount |
29634.18 |
Total Medicare Payment Amount |
22880.56 |
Total Medicare Standardized Payment Amount |
23657.57 |
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 |
14 |
Number Of Medical Services |
284 |
Number Of Medicare Beneficiaries With Medical Services |
151 |
Total Medical Submitted Charge Amount |
94311.75 |
Total Medical Medicare Allowed Amount |
29634.18 |
Total Medical Medicare Payment Amount |
22880.56 |
Total Medical Medicare Standardized Payment Amount |
23657.57 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
58 |
Number Of Beneficiaries Age 75 to 84 |
37 |
Number Of Beneficiaries Age Greater 84 |
23 |
Number Of Female Beneficiaries |
84 |
Number Of Male Beneficiaries |
67 |
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 |
80 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
71 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
15 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
54 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
47 |
Percent Of With Hyperlipidemia |
45 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
31 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
2.1339 |