| National Provider Identifier [NPI]: | 1003995176 |
| Last Name Of The Provider | CRUTCHFIELD |
| First Name Of The Provider | DOUGLAS |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | C.R.N.A. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | RR 5 BOX 114 |
| Street Address 2 Of The Provider | |
| City Of The Provider | EUFAULA |
| Zip Code Of The Provider | 744329501 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | CRNA |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 17 |
| Number Of Services | 725 |
| Number Of Medicare Beneficiaries | 684 |
| Total Submitted Charge Amount | 482263 |
| Total Medicare Allowed Amount | 105562.79 |
| Total Medicare Payment Amount | 81849.3 |
| Total Medicare Standardized Payment Amount | 86107.03 |
| 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 | 17 |
| Number Of Medical Services | 725 |
| Number Of Medicare Beneficiaries With Medical Services | 684 |
| Total Medical Submitted Charge Amount | 482263 |
| Total Medical Medicare Allowed Amount | 105562.79 |
| Total Medical Medicare Payment Amount | 81849.3 |
| Total Medical Medicare Standardized Payment Amount | 86107.03 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 171 |
| Number Of Beneficiaries Age 65 to 74 | 288 |
| Number Of Beneficiaries Age 75 to 84 | 188 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 446 |
| Number Of Male Beneficiaries | 238 |
| Number Of Non Hispanic White Beneficiaries | 544 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 80 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 487 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 197 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1274 |