| National Provider Identifier [NPI]: | 1154763225 |
| Last Name Of The Provider | CREWS |
| First Name Of The Provider | WADE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | FNP-C |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 251 COUNTY ROAD 120 |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT CLOUD |
| Zip Code Of The Provider | 563034872 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 85 |
| Number Of Services | 931 |
| Number Of Medicare Beneficiaries | 136 |
| Total Submitted Charge Amount | 49991.65 |
| Total Medicare Allowed Amount | 21950.12 |
| Total Medicare Payment Amount | 16374.69 |
| Total Medicare Standardized Payment Amount | 19661.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 339 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 722 |
| Total Drug Medicare AllowedAmount | 380.1 |
| Total Drug Medicare PaymentAmount | 330.91 |
| Total Drug Medicare Standardized Payment Amount | 330.91 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 79 |
| Number Of Medical Services | 592 |
| Number Of Medicare Beneficiaries With Medical Services | 136 |
| Total Medical Submitted Charge Amount | 49269.65 |
| Total Medical Medicare Allowed Amount | 21570.02 |
| Total Medical Medicare Payment Amount | 16043.78 |
| Total Medical Medicare Standardized Payment Amount | 19330.13 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 62 |
| Number Of Beneficiaries Age 65 to 74 | 27 |
| Number Of Beneficiaries Age 75 to 84 | 30 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 67 |
| Number Of Male Beneficiaries | 69 |
| 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 | 84 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 52 |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 55 |
| Percent Of With Ischemic Heart Disease | 14 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1049 |