| National Provider Identifier [NPI]: | 1043279763 |
| Last Name Of The Provider | CRIMMINS |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1500 CROWNE ORMOND LN |
| Street Address 2 Of The Provider | APT 421 |
| City Of The Provider | ORMOND BEACH |
| Zip Code Of The Provider | 321740643 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 171 |
| Number Of Services | 4038 |
| Number Of Medicare Beneficiaries | 2422 |
| Total Submitted Charge Amount | 413376 |
| Total Medicare Allowed Amount | 114103.63 |
| Total Medicare Payment Amount | 88811.26 |
| Total Medicare Standardized Payment Amount | 89038.31 |
| 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 | 171 |
| Number Of Medical Services | 4038 |
| Number Of Medicare Beneficiaries With Medical Services | 2422 |
| Total Medical Submitted Charge Amount | 413376 |
| Total Medical Medicare Allowed Amount | 114103.63 |
| Total Medical Medicare Payment Amount | 88811.26 |
| Total Medical Medicare Standardized Payment Amount | 89038.31 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 413 |
| Number Of Beneficiaries Age 65 to 74 | 801 |
| Number Of Beneficiaries Age 75 to 84 | 761 |
| Number Of Beneficiaries Age Greater 84 | 447 |
| Number Of Female Beneficiaries | 1563 |
| Number Of Male Beneficiaries | 859 |
| Number Of Non Hispanic White Beneficiaries | 1980 |
| Number Of Black or African American Beneficiaries | 159 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 244 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1702 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 720 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 33 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 32 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8087 |