National Provider Identifier [NPI]: |
1851374979 |
Last Name Of The Provider |
KRAFT |
First Name Of The Provider |
ROD |
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 |
1630 E HERNDON AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
FRESNO |
Zip Code Of The Provider |
937203305 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
123 |
Number Of Services |
4592 |
Number Of Medicare Beneficiaries |
592 |
Total Submitted Charge Amount |
604366 |
Total Medicare Allowed Amount |
291116.08 |
Total Medicare Payment Amount |
212413.83 |
Total Medicare Standardized Payment Amount |
204772.23 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
15 |
Number Of Drug Services |
941 |
Number Of Medicare Beneficiaries With Drug Services |
242 |
Total Drug Submitted ChargeAmount |
79677 |
Total Drug Medicare AllowedAmount |
40379.68 |
Total Drug Medicare PaymentAmount |
32333.4 |
Total Drug Medicare Standardized Payment Amount |
32333.4 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
108 |
Number Of Medical Services |
3651 |
Number Of Medicare Beneficiaries With Medical Services |
592 |
Total Medical Submitted Charge Amount |
524689 |
Total Medical Medicare Allowed Amount |
250736.4 |
Total Medical Medicare Payment Amount |
180080.43 |
Total Medical Medicare Standardized Payment Amount |
172438.83 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
20 |
Number Of Beneficiaries Age 65 to 74 |
378 |
Number Of Beneficiaries Age 75 to 84 |
141 |
Number Of Beneficiaries Age Greater 84 |
53 |
Number Of Female Beneficiaries |
291 |
Number Of Male Beneficiaries |
301 |
Number Of Non Hispanic White Beneficiaries |
541 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
30 |
Number Of American Indian Alaska Native Beneficiaries |
|
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 |
7 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
3 |
Percent Of With Depression |
6 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.7189 |