| National Provider Identifier [NPI]: | 1124259460 |
| Last Name Of The Provider | RIVELL |
| First Name Of The Provider | CRYSTAL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 110 N WOODBURY RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PITMAN |
| Zip Code Of The Provider | 080711261 |
| State Code Of The Provider | NJ |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 36 |
| Number Of Services | 968 |
| Number Of Medicare Beneficiaries | 409 |
| Total Submitted Charge Amount | 181679 |
| Total Medicare Allowed Amount | 92005.38 |
| Total Medicare Payment Amount | 66950.19 |
| Total Medicare Standardized Payment Amount | 62991.45 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 41 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 2259 |
| Total Drug Medicare AllowedAmount | 951.11 |
| Total Drug Medicare PaymentAmount | 924.61 |
| Total Drug Medicare Standardized Payment Amount | 924.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 927 |
| Number Of Medicare Beneficiaries With Medical Services | 408 |
| Total Medical Submitted Charge Amount | 179420 |
| Total Medical Medicare Allowed Amount | 91054.27 |
| Total Medical Medicare Payment Amount | 66025.58 |
| Total Medical Medicare Standardized Payment Amount | 62066.84 |
| Average Age Of Beneficiaries | 80 |
| Number Of Beneficiaries Age Less65 | 26 |
| Number Of Beneficiaries Age 65 to 74 | 115 |
| Number Of Beneficiaries Age 75 to 84 | 101 |
| Number Of Beneficiaries Age Greater 84 | 167 |
| Number Of Female Beneficiaries | 292 |
| Number Of Male Beneficiaries | 117 |
| Number Of Non Hispanic White Beneficiaries | 392 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 342 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 67 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 38 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3235 |