| National Provider Identifier [NPI]: | 1265466064 |
| Last Name Of The Provider | CRAIN |
| First Name Of The Provider | MICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 28 CRESCENT ST |
| Street Address 2 Of The Provider | MIDDLESEX HOSPITAL |
| City Of The Provider | MIDDLETOWN |
| Zip Code Of The Provider | 064573654 |
| State Code Of The Provider | CT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 228 |
| Number Of Services | 14888 |
| Number Of Medicare Beneficiaries | 3914 |
| Total Submitted Charge Amount | 1158349.12 |
| Total Medicare Allowed Amount | 346103.97 |
| Total Medicare Payment Amount | 268525.71 |
| Total Medicare Standardized Payment Amount | 250984.37 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 8202 |
| Number Of Medicare Beneficiaries With Drug Services | 98 |
| Total Drug Submitted ChargeAmount | 7035.2 |
| Total Drug Medicare AllowedAmount | 2035.38 |
| Total Drug Medicare PaymentAmount | 1577.71 |
| Total Drug Medicare Standardized Payment Amount | 1577.71 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 226 |
| Number Of Medical Services | 6686 |
| Number Of Medicare Beneficiaries With Medical Services | 3914 |
| Total Medical Submitted Charge Amount | 1151313.92 |
| Total Medical Medicare Allowed Amount | 344068.59 |
| Total Medical Medicare Payment Amount | 266948 |
| Total Medical Medicare Standardized Payment Amount | 249406.66 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 544 |
| Number Of Beneficiaries Age 65 to 74 | 1322 |
| Number Of Beneficiaries Age 75 to 84 | 1168 |
| Number Of Beneficiaries Age Greater 84 | 880 |
| Number Of Female Beneficiaries | 2494 |
| Number Of Male Beneficiaries | 1420 |
| Number Of Non Hispanic White Beneficiaries | 3578 |
| Number Of Black or African American Beneficiaries | 136 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 89 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 81 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2777 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1137 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 25 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.4733 |