| National Provider Identifier [NPI]: | 1730223181 |
| Last Name Of The Provider | MA |
| First Name Of The Provider | CAROL |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1613 N MILLS AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ORLANDO |
| Zip Code Of The Provider | 328031849 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 5997 |
| Number Of Medicare Beneficiaries | 1016 |
| Total Submitted Charge Amount | 1436476 |
| Total Medicare Allowed Amount | 585806.89 |
| Total Medicare Payment Amount | 447309.74 |
| Total Medicare Standardized Payment Amount | 454769.58 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 1427 |
| Number Of Medicare Beneficiaries With Drug Services | 173 |
| Total Drug Submitted ChargeAmount | 75730 |
| Total Drug Medicare AllowedAmount | 26981 |
| Total Drug Medicare PaymentAmount | 20752.33 |
| Total Drug Medicare Standardized Payment Amount | 20752.33 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 58 |
| Number Of Medical Services | 4570 |
| Number Of Medicare Beneficiaries With Medical Services | 1016 |
| Total Medical Submitted Charge Amount | 1360746 |
| Total Medical Medicare Allowed Amount | 558825.89 |
| Total Medical Medicare Payment Amount | 426557.41 |
| Total Medical Medicare Standardized Payment Amount | 434017.25 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 90 |
| Number Of Beneficiaries Age 65 to 74 | 379 |
| Number Of Beneficiaries Age 75 to 84 | 336 |
| Number Of Beneficiaries Age Greater 84 | 211 |
| Number Of Female Beneficiaries | 633 |
| Number Of Male Beneficiaries | 383 |
| Number Of Non Hispanic White Beneficiaries | 828 |
| Number Of Black or African American Beneficiaries | 74 |
| Number Of AsianPacific Islander Beneficiaries | 22 |
| Number Of Hispanic Beneficiaries | 68 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 24 |
| Number Of Beneficiaries With Medicare Only Entitlement | 895 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 121 |
| Percent Of With Atrial Fibrillation | 34 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 70 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.8285 |