| National Provider Identifier [NPI]: | 1861785032 |
| Last Name Of The Provider | LARSEN |
| First Name Of The Provider | SHARON |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | FNP-BC |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 650 DAKOTA ST |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | CRYSTAL LAKE |
| Zip Code Of The Provider | 600123744 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 39 |
| Number Of Services | 740 |
| Number Of Medicare Beneficiaries | 307 |
| Total Submitted Charge Amount | 101187 |
| Total Medicare Allowed Amount | 39739.67 |
| Total Medicare Payment Amount | 28340.67 |
| Total Medicare Standardized Payment Amount | 35072.57 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 34 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 397 |
| Total Drug Medicare AllowedAmount | 141.48 |
| Total Drug Medicare PaymentAmount | 120.27 |
| Total Drug Medicare Standardized Payment Amount | 120.27 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 33 |
| Number Of Medical Services | 706 |
| Number Of Medicare Beneficiaries With Medical Services | 307 |
| Total Medical Submitted Charge Amount | 100790 |
| Total Medical Medicare Allowed Amount | 39598.19 |
| Total Medical Medicare Payment Amount | 28220.4 |
| Total Medical Medicare Standardized Payment Amount | 34952.3 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 27 |
| Number Of Beneficiaries Age 65 to 74 | 148 |
| Number Of Beneficiaries Age 75 to 84 | 98 |
| Number Of Beneficiaries Age Greater 84 | 34 |
| Number Of Female Beneficiaries | 200 |
| Number Of Male Beneficiaries | 107 |
| Number Of Non Hispanic White Beneficiaries | 296 |
| Number Of Black or African American Beneficiaries | 0 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 284 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 23 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 37 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.0841 |