| National Provider Identifier [NPI]: | 1215166871 |
| Last Name Of The Provider | CRAWFORD |
| First Name Of The Provider | BENJAMIN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4612 S HARVARD AVE |
| Street Address 2 Of The Provider | STE A |
| City Of The Provider | TULSA |
| Zip Code Of The Provider | 741352908 |
| State Code Of The Provider | OK |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychiatry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 11 |
| Number Of Services | 616 |
| Number Of Medicare Beneficiaries | 247 |
| Total Submitted Charge Amount | 66143.64 |
| Total Medicare Allowed Amount | 52969.72 |
| Total Medicare Payment Amount | 39406.95 |
| Total Medicare Standardized Payment Amount | 41520.04 |
| 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 | 11 |
| Number Of Medical Services | 616 |
| Number Of Medicare Beneficiaries With Medical Services | 247 |
| Total Medical Submitted Charge Amount | 66143.64 |
| Total Medical Medicare Allowed Amount | 52969.72 |
| Total Medical Medicare Payment Amount | 39406.95 |
| Total Medical Medicare Standardized Payment Amount | 41520.04 |
| Average Age Of Beneficiaries | 48 |
| Number Of Beneficiaries Age Less65 | 223 |
| Number Of Beneficiaries Age 65 to 74 | |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 110 |
| Number Of Male Beneficiaries | 137 |
| Number Of Non Hispanic White Beneficiaries | 140 |
| Number Of Black or African American Beneficiaries | 66 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 26 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 45 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 202 |
| Percent Of With Atrial Fibrillation | 0 |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 5 |
| Percent Of With Chronic Kidney Disease | 9 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 53 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 21 |
| Percent Of With Hypertension | 40 |
| Percent Of With Ischemic Heart Disease | 8 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 22 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 66 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.1069 |