| National Provider Identifier [NPI]: | 1942277215 |
| Last Name Of The Provider | CROCKETT |
| First Name Of The Provider | FRANK |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2115 W MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | DOTHAN |
| Zip Code Of The Provider | 363011289 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 10740 |
| Number Of Medicare Beneficiaries | 1896 |
| Total Submitted Charge Amount | 659742 |
| Total Medicare Allowed Amount | 553271.31 |
| Total Medicare Payment Amount | 417726.74 |
| Total Medicare Standardized Payment Amount | 415022.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 1731 |
| Number Of Medicare Beneficiaries With Drug Services | 582 |
| Total Drug Submitted ChargeAmount | 33068 |
| Total Drug Medicare AllowedAmount | 17902.48 |
| Total Drug Medicare PaymentAmount | 17109.68 |
| Total Drug Medicare Standardized Payment Amount | 17109.68 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 9009 |
| Number Of Medicare Beneficiaries With Medical Services | 1896 |
| Total Medical Submitted Charge Amount | 626674 |
| Total Medical Medicare Allowed Amount | 535368.83 |
| Total Medical Medicare Payment Amount | 400617.06 |
| Total Medical Medicare Standardized Payment Amount | 397913.13 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 293 |
| Number Of Beneficiaries Age 65 to 74 | 605 |
| Number Of Beneficiaries Age 75 to 84 | 668 |
| Number Of Beneficiaries Age Greater 84 | 330 |
| Number Of Female Beneficiaries | 1149 |
| Number Of Male Beneficiaries | 747 |
| Number Of Non Hispanic White Beneficiaries | 1560 |
| Number Of Black or African American Beneficiaries | 317 |
| 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 | 1392 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 504 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 50 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.5905 |