| National Provider Identifier [NPI]: | 1942434998 |
| Last Name Of The Provider | LARSON |
| First Name Of The Provider | CASEY |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | ARNP |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1409 KINGSLEY AVE |
| Street Address 2 Of The Provider | SUITE 6A |
| City Of The Provider | ORANGE PARK |
| Zip Code Of The Provider | 320734537 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nurse Practitioner |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 16 |
| Number Of Services | 554 |
| Number Of Medicare Beneficiaries | 287 |
| Total Submitted Charge Amount | 20059.85 |
| Total Medicare Allowed Amount | 18874.41 |
| Total Medicare Payment Amount | 15477.3 |
| Total Medicare Standardized Payment Amount | 17606.4 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 220 |
| Number Of Medicare Beneficiaries With Drug Services | 207 |
| Total Drug Submitted ChargeAmount | 6457.85 |
| Total Drug Medicare AllowedAmount | 6457.85 |
| Total Drug Medicare PaymentAmount | 6161.09 |
| Total Drug Medicare Standardized Payment Amount | 6161.09 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 10 |
| Number Of Medical Services | 334 |
| Number Of Medicare Beneficiaries With Medical Services | 285 |
| Total Medical Submitted Charge Amount | 13602 |
| Total Medical Medicare Allowed Amount | 12416.56 |
| Total Medical Medicare Payment Amount | 9316.21 |
| Total Medical Medicare Standardized Payment Amount | 11445.31 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 17 |
| Number Of Beneficiaries Age 65 to 74 | 179 |
| Number Of Beneficiaries Age 75 to 84 | 75 |
| Number Of Beneficiaries Age Greater 84 | 16 |
| Number Of Female Beneficiaries | 174 |
| Number Of Male Beneficiaries | 113 |
| Number Of Non Hispanic White Beneficiaries | 269 |
| Number Of Black or African American Beneficiaries | |
| 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 | 273 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 14 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 5 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 8 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 11 |
| Percent Of With Diabetes | 25 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 57 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 0.8347 |