National Provider Identifier [NPI]: |
1417906769 |
Last Name Of The Provider |
CRAWFORD |
First Name Of The Provider |
BRIAN |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2222 N NEVADA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
COLORADO SPRINGS |
Zip Code Of The Provider |
809076831 |
State Code Of The Provider |
CO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
691 |
Number Of Medicare Beneficiaries |
639 |
Total Submitted Charge Amount |
358848 |
Total Medicare Allowed Amount |
109517.09 |
Total Medicare Payment Amount |
84096.49 |
Total Medicare Standardized Payment Amount |
84309.09 |
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 |
23 |
Number Of Medical Services |
691 |
Number Of Medicare Beneficiaries With Medical Services |
639 |
Total Medical Submitted Charge Amount |
358848 |
Total Medical Medicare Allowed Amount |
109517.09 |
Total Medical Medicare Payment Amount |
84096.49 |
Total Medical Medicare Standardized Payment Amount |
84309.09 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
141 |
Number Of Beneficiaries Age 65 to 74 |
185 |
Number Of Beneficiaries Age 75 to 84 |
171 |
Number Of Beneficiaries Age Greater 84 |
142 |
Number Of Female Beneficiaries |
364 |
Number Of Male Beneficiaries |
275 |
Number Of Non Hispanic White Beneficiaries |
542 |
Number Of Black or African American Beneficiaries |
34 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
40 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
490 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
149 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
27 |
Percent Of With Chronic Kidney Disease |
35 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
35 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
9 |
Average HCC Risk Score Of Beneficiaries |
1.6297 |