| National Provider Identifier [NPI]: | 1851568117 |
| Last Name Of The Provider | CRISWELL |
| First Name Of The Provider | BRADEN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2627 E WASHINGTON BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | PASADENA |
| Zip Code Of The Provider | 911071412 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 97 |
| Number Of Services | 713 |
| Number Of Medicare Beneficiaries | 240 |
| Total Submitted Charge Amount | 250784.4 |
| Total Medicare Allowed Amount | 62777.34 |
| Total Medicare Payment Amount | 48749.04 |
| Total Medicare Standardized Payment Amount | 44660.35 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 56 |
| Number Of Medicare Beneficiaries With Drug Services | 15 |
| Total Drug Submitted ChargeAmount | 540 |
| Total Drug Medicare AllowedAmount | 113.61 |
| Total Drug Medicare PaymentAmount | 89.1 |
| Total Drug Medicare Standardized Payment Amount | 89.1 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 95 |
| Number Of Medical Services | 657 |
| Number Of Medicare Beneficiaries With Medical Services | 240 |
| Total Medical Submitted Charge Amount | 250244.4 |
| Total Medical Medicare Allowed Amount | 62663.73 |
| Total Medical Medicare Payment Amount | 48659.94 |
| Total Medical Medicare Standardized Payment Amount | 44571.25 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 106 |
| Number Of Beneficiaries Age 75 to 84 | 73 |
| Number Of Beneficiaries Age Greater 84 | 30 |
| Number Of Female Beneficiaries | 166 |
| Number Of Male Beneficiaries | 74 |
| Number Of Non Hispanic White Beneficiaries | 178 |
| Number Of Black or African American Beneficiaries | 13 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 31 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 183 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 57 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 21 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 63 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 65 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2548 |