| National Provider Identifier [NPI]: | 1215964614 |
| Last Name Of The Provider | CRANDELL |
| First Name Of The Provider | BLAIN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 123 BJUNE DR SE |
| Street Address 2 Of The Provider | SUITE 101 |
| City Of The Provider | BAINBRIDGE ISLAND |
| Zip Code Of The Provider | 981102459 |
| State Code Of The Provider | WA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 81 |
| Number Of Services | 1367 |
| Number Of Medicare Beneficiaries | 221 |
| Total Submitted Charge Amount | 130941.56 |
| Total Medicare Allowed Amount | 75832.71 |
| Total Medicare Payment Amount | 57842.89 |
| Total Medicare Standardized Payment Amount | 58224.14 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 150 |
| Number Of Medicare Beneficiaries With Drug Services | 74 |
| Total Drug Submitted ChargeAmount | 5917.74 |
| Total Drug Medicare AllowedAmount | 4857.99 |
| Total Drug Medicare PaymentAmount | 4723.2 |
| Total Drug Medicare Standardized Payment Amount | 4723.2 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 68 |
| Number Of Medical Services | 1217 |
| Number Of Medicare Beneficiaries With Medical Services | 221 |
| Total Medical Submitted Charge Amount | 125023.82 |
| Total Medical Medicare Allowed Amount | 70974.72 |
| Total Medical Medicare Payment Amount | 53119.69 |
| Total Medical Medicare Standardized Payment Amount | 53500.94 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 22 |
| Number Of Beneficiaries Age 65 to 74 | 107 |
| Number Of Beneficiaries Age 75 to 84 | 53 |
| Number Of Beneficiaries Age Greater 84 | 39 |
| Number Of Female Beneficiaries | 106 |
| Number Of Male Beneficiaries | 115 |
| 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 | 202 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 19 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 8 |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 14 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 50 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 5 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 31 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.8318 |