| National Provider Identifier [NPI]: | 1528008695 |
| Last Name Of The Provider | CALDWELL |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1020 W FERTITTA BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LEESVILLE |
| Zip Code Of The Provider | 714464649 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 161 |
| Number Of Services | 6653 |
| Number Of Medicare Beneficiaries | 2236 |
| Total Submitted Charge Amount | 710411 |
| Total Medicare Allowed Amount | 165422.18 |
| Total Medicare Payment Amount | 124578.92 |
| Total Medicare Standardized Payment Amount | 130817.73 |
| 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 | 161 |
| Number Of Medical Services | 6653 |
| Number Of Medicare Beneficiaries With Medical Services | 2236 |
| Total Medical Submitted Charge Amount | 710411 |
| Total Medical Medicare Allowed Amount | 165422.18 |
| Total Medical Medicare Payment Amount | 124578.92 |
| Total Medical Medicare Standardized Payment Amount | 130817.73 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 548 |
| Number Of Beneficiaries Age 65 to 74 | 892 |
| Number Of Beneficiaries Age 75 to 84 | 608 |
| Number Of Beneficiaries Age Greater 84 | 188 |
| Number Of Female Beneficiaries | 1414 |
| Number Of Male Beneficiaries | 822 |
| Number Of Non Hispanic White Beneficiaries | 1760 |
| Number Of Black or African American Beneficiaries | 352 |
| Number Of AsianPacific Islander Beneficiaries | 35 |
| Number Of Hispanic Beneficiaries | 67 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1454 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 782 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | 51 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.6037 |