| National Provider Identifier [NPI]: | 1487828596 |
| Last Name Of The Provider | CRUM |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 837 S FLEISHEL AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757012017 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 286 |
| Number Of Services | 12318 |
| Number Of Medicare Beneficiaries | 8024 |
| Total Submitted Charge Amount | 1665263.5 |
| Total Medicare Allowed Amount | 440238.9 |
| Total Medicare Payment Amount | 338106.57 |
| Total Medicare Standardized Payment Amount | 357011.49 |
| 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 | 286 |
| Number Of Medical Services | 12318 |
| Number Of Medicare Beneficiaries With Medical Services | 8024 |
| Total Medical Submitted Charge Amount | 1665263.5 |
| Total Medical Medicare Allowed Amount | 440238.9 |
| Total Medical Medicare Payment Amount | 338106.57 |
| Total Medical Medicare Standardized Payment Amount | 357011.49 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 1400 |
| Number Of Beneficiaries Age 65 to 74 | 3019 |
| Number Of Beneficiaries Age 75 to 84 | 2388 |
| Number Of Beneficiaries Age Greater 84 | 1217 |
| Number Of Female Beneficiaries | 4490 |
| Number Of Male Beneficiaries | 3534 |
| Number Of Non Hispanic White Beneficiaries | 6799 |
| Number Of Black or African American Beneficiaries | 943 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 216 |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | 34 |
| Number Of Beneficiaries With Medicare Only Entitlement | 6033 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1991 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 51 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.7106 |