| National Provider Identifier [NPI]: | 1659315737 |
| Last Name Of The Provider | ODDIS |
| First Name Of The Provider | CARMINE |
| Middle Initial Of The Provider | V |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 682 HEMLOCK ST |
| Street Address 2 Of The Provider | SUITE 490 |
| City Of The Provider | MACON |
| Zip Code Of The Provider | 312018307 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 95 |
| Number Of Services | 17714 |
| Number Of Medicare Beneficiaries | 2941 |
| Total Submitted Charge Amount | 3912156 |
| Total Medicare Allowed Amount | 1303474.66 |
| Total Medicare Payment Amount | 980424.33 |
| Total Medicare Standardized Payment Amount | 1041510.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 485 |
| Number Of Medicare Beneficiaries With Drug Services | 97 |
| Total Drug Submitted ChargeAmount | 65960 |
| Total Drug Medicare AllowedAmount | 20812.22 |
| Total Drug Medicare PaymentAmount | 15990.83 |
| Total Drug Medicare Standardized Payment Amount | 15990.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 93 |
| Number Of Medical Services | 17229 |
| Number Of Medicare Beneficiaries With Medical Services | 2941 |
| Total Medical Submitted Charge Amount | 3846196 |
| Total Medical Medicare Allowed Amount | 1282662.44 |
| Total Medical Medicare Payment Amount | 964433.5 |
| Total Medical Medicare Standardized Payment Amount | 1025519.94 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 301 |
| Number Of Beneficiaries Age 65 to 74 | 1013 |
| Number Of Beneficiaries Age 75 to 84 | 1092 |
| Number Of Beneficiaries Age Greater 84 | 535 |
| Number Of Female Beneficiaries | 1482 |
| Number Of Male Beneficiaries | 1459 |
| Number Of Non Hispanic White Beneficiaries | 2534 |
| Number Of Black or African American Beneficiaries | 377 |
| 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 | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2537 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 404 |
| Percent Of With Atrial Fibrillation | 45 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 45 |
| Percent Of With Chronic Kidney Disease | 37 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 24 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 66 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.7307 |