| National Provider Identifier [NPI]: | 1134437411 |
| Last Name Of The Provider | TAYLOR |
| First Name Of The Provider | CRYSTAL |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 445 E 10TH ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BAXTER SPRINGS |
| Zip Code Of The Provider | 667131614 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 14 |
| Number Of Services | 1667 |
| Number Of Medicare Beneficiaries | 262 |
| Total Submitted Charge Amount | 166870.5 |
| Total Medicare Allowed Amount | 91913.21 |
| Total Medicare Payment Amount | 65098.39 |
| Total Medicare Standardized Payment Amount | 83444.25 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 164 |
| Number Of Medicare Beneficiaries With Drug Services | 40 |
| Total Drug Submitted ChargeAmount | 6587.5 |
| Total Drug Medicare AllowedAmount | 161.56 |
| Total Drug Medicare PaymentAmount | 138.67 |
| Total Drug Medicare Standardized Payment Amount | 138.67 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 1503 |
| Number Of Medicare Beneficiaries With Medical Services | 261 |
| Total Medical Submitted Charge Amount | 160283 |
| Total Medical Medicare Allowed Amount | 91751.65 |
| Total Medical Medicare Payment Amount | 64959.72 |
| Total Medical Medicare Standardized Payment Amount | 83305.58 |
| Average Age Of Beneficiaries | 61 |
| Number Of Beneficiaries Age Less65 | 141 |
| Number Of Beneficiaries Age 65 to 74 | 70 |
| Number Of Beneficiaries Age 75 to 84 | 31 |
| Number Of Beneficiaries Age Greater 84 | 20 |
| Number Of Female Beneficiaries | 157 |
| Number Of Male Beneficiaries | 105 |
| Number Of Non Hispanic White Beneficiaries | 245 |
| 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 | 103 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 159 |
| Percent Of With Atrial Fibrillation | 6 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 19 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 46 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 54 |
| Percent Of With Ischemic Heart Disease | 35 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4911 |