| National Provider Identifier [NPI]: | 1669634796 |
| Last Name Of The Provider | CRENSHAW |
| First Name Of The Provider | BRYAN |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 4126 W MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOTHAN |
| Zip Code Of The Provider | 363059310 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 87 |
| Number Of Services | 3604 |
| Number Of Medicare Beneficiaries | 410 |
| Total Submitted Charge Amount | 160852 |
| Total Medicare Allowed Amount | 104285.28 |
| Total Medicare Payment Amount | 72465.63 |
| Total Medicare Standardized Payment Amount | 80184.5 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 154 |
| Number Of Medicare Beneficiaries With Drug Services | 82 |
| Total Drug Submitted ChargeAmount | 2242 |
| Total Drug Medicare AllowedAmount | 1344.35 |
| Total Drug Medicare PaymentAmount | 1175.23 |
| Total Drug Medicare Standardized Payment Amount | 1175.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 3450 |
| Number Of Medicare Beneficiaries With Medical Services | 410 |
| Total Medical Submitted Charge Amount | 158610 |
| Total Medical Medicare Allowed Amount | 102940.93 |
| Total Medical Medicare Payment Amount | 71290.4 |
| Total Medical Medicare Standardized Payment Amount | 79009.27 |
| Average Age Of Beneficiaries | 68 |
| Number Of Beneficiaries Age Less65 | 88 |
| Number Of Beneficiaries Age 65 to 74 | 207 |
| Number Of Beneficiaries Age 75 to 84 | 95 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 219 |
| Number Of Male Beneficiaries | 191 |
| Number Of Non Hispanic White Beneficiaries | 343 |
| 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 | 341 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 69 |
| Percent Of With Atrial Fibrillation | 5 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 7 |
| Percent Of With Chronic Kidney Disease | 13 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 28 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 29 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.911 |