| National Provider Identifier [NPI]: | 1275693921 |
| Last Name Of The Provider | CRISP |
| First Name Of The Provider | LARRY |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | CFNP |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 389 RIVER RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DECATUR |
| Zip Code Of The Provider | 373220157 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 38 |
| Number Of Services | 1380 |
| Number Of Medicare Beneficiaries | 327 |
| Total Submitted Charge Amount | 73407 |
| Total Medicare Allowed Amount | 41059.9 |
| Total Medicare Payment Amount | 28841.52 |
| Total Medicare Standardized Payment Amount | 37358.3 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 651 |
| Number Of Medicare Beneficiaries With Drug Services | 114 |
| Total Drug Submitted ChargeAmount | 3860 |
| Total Drug Medicare AllowedAmount | 768.36 |
| Total Drug Medicare PaymentAmount | 611.39 |
| Total Drug Medicare Standardized Payment Amount | 611.39 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 28 |
| Number Of Medical Services | 729 |
| Number Of Medicare Beneficiaries With Medical Services | 327 |
| Total Medical Submitted Charge Amount | 69547 |
| Total Medical Medicare Allowed Amount | 40291.54 |
| Total Medical Medicare Payment Amount | 28230.13 |
| Total Medical Medicare Standardized Payment Amount | 36746.91 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 61 |
| Number Of Beneficiaries Age 65 to 74 | 117 |
| Number Of Beneficiaries Age 75 to 84 | 103 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 195 |
| Number Of Male Beneficiaries | 132 |
| Number Of Non Hispanic White Beneficiaries | |
| 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 | 232 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 95 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 39 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2875 |