| National Provider Identifier [NPI]: | 1851453534 |
| Last Name Of The Provider | CRISP |
| First Name Of The Provider | MATTHEW |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | SCOTT & WHITE HEALTHCARE RADIOLOGY |
| Street Address 2 Of The Provider | 2401 S 31ST ST |
| City Of The Provider | TEMPLE |
| Zip Code Of The Provider | 765080001 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 119 |
| Number Of Services | 4459 |
| Number Of Medicare Beneficiaries | 2749 |
| Total Submitted Charge Amount | 395082 |
| Total Medicare Allowed Amount | 85653.03 |
| Total Medicare Payment Amount | 62820.72 |
| Total Medicare Standardized Payment Amount | 65685.82 |
| 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 | 119 |
| Number Of Medical Services | 4459 |
| Number Of Medicare Beneficiaries With Medical Services | 2749 |
| Total Medical Submitted Charge Amount | 395082 |
| Total Medical Medicare Allowed Amount | 85653.03 |
| Total Medical Medicare Payment Amount | 62820.72 |
| Total Medical Medicare Standardized Payment Amount | 65685.82 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 638 |
| Number Of Beneficiaries Age 65 to 74 | 991 |
| Number Of Beneficiaries Age 75 to 84 | 732 |
| Number Of Beneficiaries Age Greater 84 | 388 |
| Number Of Female Beneficiaries | 1579 |
| Number Of Male Beneficiaries | 1170 |
| Number Of Non Hispanic White Beneficiaries | 2034 |
| Number Of Black or African American Beneficiaries | 361 |
| Number Of AsianPacific Islander Beneficiaries | 32 |
| Number Of Hispanic Beneficiaries | 298 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1952 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 797 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 47 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 28 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 14 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.9988 |