| National Provider Identifier [NPI]: | 1003088972 |
| Last Name Of The Provider | CRACE |
| First Name Of The Provider | PHILLIP |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 UNIVERSITY DR |
| Street Address 2 Of The Provider | SUITE 212 |
| City Of The Provider | PRESTONSBURG |
| Zip Code Of The Provider | 416531080 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 141 |
| Number Of Services | 2124 |
| Number Of Medicare Beneficiaries | 489 |
| Total Submitted Charge Amount | 397670 |
| Total Medicare Allowed Amount | 217124.68 |
| Total Medicare Payment Amount | 166349.45 |
| Total Medicare Standardized Payment Amount | 174969.8 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 9 |
| Number Of Drug Services | 212 |
| Number Of Medicare Beneficiaries With Drug Services | 53 |
| Total Drug Submitted ChargeAmount | 2981 |
| Total Drug Medicare AllowedAmount | 739.38 |
| Total Drug Medicare PaymentAmount | 693.41 |
| Total Drug Medicare Standardized Payment Amount | 693.41 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 132 |
| Number Of Medical Services | 1912 |
| Number Of Medicare Beneficiaries With Medical Services | 489 |
| Total Medical Submitted Charge Amount | 394689 |
| Total Medical Medicare Allowed Amount | 216385.3 |
| Total Medical Medicare Payment Amount | 165656.04 |
| Total Medical Medicare Standardized Payment Amount | 174276.39 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 112 |
| Number Of Beneficiaries Age 65 to 74 | 180 |
| Number Of Beneficiaries Age 75 to 84 | 144 |
| Number Of Beneficiaries Age Greater 84 | 53 |
| Number Of Female Beneficiaries | 295 |
| Number Of Male Beneficiaries | 194 |
| Number Of Non Hispanic White Beneficiaries | 266 |
| 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 | 229 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 260 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 50 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.5485 |