| National Provider Identifier [NPI]: | 1104125780 |
| Last Name Of The Provider | CRANDALL |
| First Name Of The Provider | KEITH |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | DPM |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 9209 STONEBANK XING |
| Street Address 2 Of The Provider | |
| City Of The Provider | TYLER |
| Zip Code Of The Provider | 757030829 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Podiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 61 |
| Number Of Services | 9608 |
| Number Of Medicare Beneficiaries | 2805 |
| Total Submitted Charge Amount | 1071044 |
| Total Medicare Allowed Amount | 612677.87 |
| Total Medicare Payment Amount | 464501.16 |
| Total Medicare Standardized Payment Amount | 493499.69 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 46 |
| Number Of Medicare Beneficiaries With Drug Services | 38 |
| Total Drug Submitted ChargeAmount | 1380 |
| Total Drug Medicare AllowedAmount | 82.61 |
| Total Drug Medicare PaymentAmount | 59.1 |
| Total Drug Medicare Standardized Payment Amount | 59.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 9562 |
| Number Of Medicare Beneficiaries With Medical Services | 2805 |
| Total Medical Submitted Charge Amount | 1069664 |
| Total Medical Medicare Allowed Amount | 612595.26 |
| Total Medical Medicare Payment Amount | 464442.06 |
| Total Medical Medicare Standardized Payment Amount | 493440.59 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 308 |
| Number Of Beneficiaries Age 65 to 74 | 563 |
| Number Of Beneficiaries Age 75 to 84 | 819 |
| Number Of Beneficiaries Age Greater 84 | 1115 |
| Number Of Female Beneficiaries | 1849 |
| Number Of Male Beneficiaries | 956 |
| Number Of Non Hispanic White Beneficiaries | 2325 |
| Number Of Black or African American Beneficiaries | 422 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1132 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1673 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 66 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 47 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 20 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.9702 |