National Provider Identifier [NPI]: |
1891784229 |
Last Name Of The Provider |
CRABBE |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
320 KENNESTONE HOSPITAL BLVD |
Street Address 2 Of The Provider |
SUITE 201 |
City Of The Provider |
MARIETTA |
Zip Code Of The Provider |
300601161 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
2963 |
Number Of Medicare Beneficiaries |
869 |
Total Submitted Charge Amount |
372460 |
Total Medicare Allowed Amount |
182722.65 |
Total Medicare Payment Amount |
142247.13 |
Total Medicare Standardized Payment Amount |
142470.15 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
488 |
Number Of Medicare Beneficiaries With Drug Services |
301 |
Total Drug Submitted ChargeAmount |
22759 |
Total Drug Medicare AllowedAmount |
11384.56 |
Total Drug Medicare PaymentAmount |
11071.67 |
Total Drug Medicare Standardized Payment Amount |
11071.67 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
29 |
Number Of Medical Services |
2475 |
Number Of Medicare Beneficiaries With Medical Services |
869 |
Total Medical Submitted Charge Amount |
349701 |
Total Medical Medicare Allowed Amount |
171338.09 |
Total Medical Medicare Payment Amount |
131175.46 |
Total Medical Medicare Standardized Payment Amount |
131398.48 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
382 |
Number Of Beneficiaries Age 75 to 84 |
315 |
Number Of Beneficiaries Age Greater 84 |
139 |
Number Of Female Beneficiaries |
438 |
Number Of Male Beneficiaries |
431 |
Number Of Non Hispanic White Beneficiaries |
840 |
Number Of Black or African American Beneficiaries |
16 |
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 |
838 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
31 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
14 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
17 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
21 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
53 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
28 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.9633 |