National Provider Identifier [NPI]: |
1811930738 |
Last Name Of The Provider |
KROUTIL |
First Name Of The Provider |
CANDISE |
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 |
1001 E PRIMROSE ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SPRINGFIELD |
Zip Code Of The Provider |
658075155 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
132 |
Number Of Services |
3856 |
Number Of Medicare Beneficiaries |
266 |
Total Submitted Charge Amount |
235337 |
Total Medicare Allowed Amount |
118497.62 |
Total Medicare Payment Amount |
94257.29 |
Total Medicare Standardized Payment Amount |
102366.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
201 |
Number Of Medicare Beneficiaries With Drug Services |
136 |
Total Drug Submitted ChargeAmount |
6002 |
Total Drug Medicare AllowedAmount |
4852.99 |
Total Drug Medicare PaymentAmount |
4690.53 |
Total Drug Medicare Standardized Payment Amount |
4690.53 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
120 |
Number Of Medical Services |
3655 |
Number Of Medicare Beneficiaries With Medical Services |
266 |
Total Medical Submitted Charge Amount |
229335 |
Total Medical Medicare Allowed Amount |
113644.63 |
Total Medical Medicare Payment Amount |
89566.76 |
Total Medical Medicare Standardized Payment Amount |
97676.09 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
140 |
Number Of Beneficiaries Age 75 to 84 |
63 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
206 |
Number Of Male Beneficiaries |
60 |
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 |
234 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
32 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
6 |
Percent Of With Heart Failure |
8 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
66 |
Percent Of With Ischemic Heart Disease |
14 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
29 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.8511 |