| National Provider Identifier [NPI]: | 1346248358 |
| Last Name Of The Provider | CARLOS |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 MEMORIAL HOSPITAL DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | MOBILE |
| Zip Code Of The Provider | 366081786 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Internal Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 148 |
| Number Of Services | 12904 |
| Number Of Medicare Beneficiaries | 1072 |
| Total Submitted Charge Amount | 648228 |
| Total Medicare Allowed Amount | 462139.3 |
| Total Medicare Payment Amount | 342256.06 |
| Total Medicare Standardized Payment Amount | 369880.85 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 2900 |
| Number Of Medicare Beneficiaries With Drug Services | 248 |
| Total Drug Submitted ChargeAmount | 50430 |
| Total Drug Medicare AllowedAmount | 30739.43 |
| Total Drug Medicare PaymentAmount | 24472.53 |
| Total Drug Medicare Standardized Payment Amount | 24472.53 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 130 |
| Number Of Medical Services | 10004 |
| Number Of Medicare Beneficiaries With Medical Services | 1072 |
| Total Medical Submitted Charge Amount | 597798 |
| Total Medical Medicare Allowed Amount | 431399.87 |
| Total Medical Medicare Payment Amount | 317783.53 |
| Total Medical Medicare Standardized Payment Amount | 345408.32 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 241 |
| Number Of Beneficiaries Age 65 to 74 | 382 |
| Number Of Beneficiaries Age 75 to 84 | 300 |
| Number Of Beneficiaries Age Greater 84 | 149 |
| Number Of Female Beneficiaries | 650 |
| Number Of Male Beneficiaries | 422 |
| Number Of Non Hispanic White Beneficiaries | 665 |
| Number Of Black or African American Beneficiaries | 390 |
| 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 | |
| Number Of Beneficiaries With Medicare Only Entitlement | 844 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 228 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 21 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 41 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4253 |