National Provider Identifier [NPI]: |
1164631255 |
Last Name Of The Provider |
CROUSE |
First Name Of The Provider |
SANDRA |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1101 SAM PERRY BLVD |
Street Address 2 Of The Provider |
SUITE 414 |
City Of The Provider |
FREDERICKSBURG |
Zip Code Of The Provider |
224014467 |
State Code Of The Provider |
VA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Neurology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
4647 |
Number Of Medicare Beneficiaries |
796 |
Total Submitted Charge Amount |
353358 |
Total Medicare Allowed Amount |
163878.47 |
Total Medicare Payment Amount |
122791.74 |
Total Medicare Standardized Payment Amount |
124615.48 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
3217 |
Number Of Medicare Beneficiaries With Drug Services |
17 |
Total Drug Submitted ChargeAmount |
35325 |
Total Drug Medicare AllowedAmount |
17737.43 |
Total Drug Medicare PaymentAmount |
13906.15 |
Total Drug Medicare Standardized Payment Amount |
13906.15 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
1430 |
Number Of Medicare Beneficiaries With Medical Services |
796 |
Total Medical Submitted Charge Amount |
318033 |
Total Medical Medicare Allowed Amount |
146141.04 |
Total Medical Medicare Payment Amount |
108885.59 |
Total Medical Medicare Standardized Payment Amount |
110709.33 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
207 |
Number Of Beneficiaries Age 65 to 74 |
264 |
Number Of Beneficiaries Age 75 to 84 |
225 |
Number Of Beneficiaries Age Greater 84 |
100 |
Number Of Female Beneficiaries |
473 |
Number Of Male Beneficiaries |
323 |
Number Of Non Hispanic White Beneficiaries |
611 |
Number Of Black or African American Beneficiaries |
158 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
550 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
246 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
31 |
Percent Of With Asthma |
14 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
25 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
69 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
48 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
36 |
Average HCC Risk Score Of Beneficiaries |
1.8476 |