National Provider Identifier [NPI]: |
1396780631 |
Last Name Of The Provider |
CROOKES |
First Name Of The Provider |
PETER |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1510 SAN PABLO ST |
Street Address 2 Of The Provider |
SUITE 514 |
City Of The Provider |
LOS ANGELES |
Zip Code Of The Provider |
900335324 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
General Surgery |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
57 |
Number Of Services |
312 |
Number Of Medicare Beneficiaries |
133 |
Total Submitted Charge Amount |
298205 |
Total Medicare Allowed Amount |
77631.92 |
Total Medicare Payment Amount |
59576.5 |
Total Medicare Standardized Payment Amount |
56900.57 |
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 |
57 |
Number Of Medical Services |
312 |
Number Of Medicare Beneficiaries With Medical Services |
133 |
Total Medical Submitted Charge Amount |
298205 |
Total Medical Medicare Allowed Amount |
77631.92 |
Total Medical Medicare Payment Amount |
59576.5 |
Total Medical Medicare Standardized Payment Amount |
56900.57 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
56 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
90 |
Number Of Male Beneficiaries |
43 |
Number Of Non Hispanic White Beneficiaries |
83 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
31 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
77 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
56 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
14 |
Percent Of With Heart Failure |
26 |
Percent Of With Chronic Kidney Disease |
32 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
44 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
53 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
2.2618 |