| National Provider Identifier [NPI]: | 1740204122 |
| Last Name Of The Provider | CHEBLI |
| First Name Of The Provider | CAROLINE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6050 CATTLERIDGE BLVD |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | SARASOTA |
| Zip Code Of The Provider | 34232 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 139 |
| Number Of Services | 5202 |
| Number Of Medicare Beneficiaries | 572 |
| Total Submitted Charge Amount | 1085349.08 |
| Total Medicare Allowed Amount | 418799.82 |
| Total Medicare Payment Amount | 319223.97 |
| Total Medicare Standardized Payment Amount | 310636.87 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 461 |
| Number Of Medicare Beneficiaries With Drug Services | 169 |
| Total Drug Submitted ChargeAmount | 6122 |
| Total Drug Medicare AllowedAmount | 2319.51 |
| Total Drug Medicare PaymentAmount | 1809.76 |
| Total Drug Medicare Standardized Payment Amount | 1809.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 136 |
| Number Of Medical Services | 4741 |
| Number Of Medicare Beneficiaries With Medical Services | 572 |
| Total Medical Submitted Charge Amount | 1079227.08 |
| Total Medical Medicare Allowed Amount | 416480.31 |
| Total Medical Medicare Payment Amount | 317414.21 |
| Total Medical Medicare Standardized Payment Amount | 308827.11 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 35 |
| Number Of Beneficiaries Age 65 to 74 | 252 |
| Number Of Beneficiaries Age 75 to 84 | 175 |
| Number Of Beneficiaries Age Greater 84 | 110 |
| Number Of Female Beneficiaries | 352 |
| Number Of Male Beneficiaries | 220 |
| Number Of Non Hispanic White Beneficiaries | 538 |
| Number Of Black or African American Beneficiaries | 12 |
| 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 | 518 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 54 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 69 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2466 |