| National Provider Identifier [NPI]: | 1871525477 |
| Last Name Of The Provider | EDDLEMON |
| First Name Of The Provider | EUGENE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 95 DECLARATION DR |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | CHICO |
| Zip Code Of The Provider | 959734916 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Peripheral Vascular Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 147 |
| Number Of Services | 1864 |
| Number Of Medicare Beneficiaries | 739 |
| Total Submitted Charge Amount | 789245.26 |
| Total Medicare Allowed Amount | 429222.71 |
| Total Medicare Payment Amount | 323304.13 |
| Total Medicare Standardized Payment Amount | 324507.38 |
| 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 | 147 |
| Number Of Medical Services | 1864 |
| Number Of Medicare Beneficiaries With Medical Services | 739 |
| Total Medical Submitted Charge Amount | 789245.26 |
| Total Medical Medicare Allowed Amount | 429222.71 |
| Total Medical Medicare Payment Amount | 323304.13 |
| Total Medical Medicare Standardized Payment Amount | 324507.38 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 97 |
| Number Of Beneficiaries Age 65 to 74 | 265 |
| Number Of Beneficiaries Age 75 to 84 | 254 |
| Number Of Beneficiaries Age Greater 84 | 123 |
| Number Of Female Beneficiaries | 330 |
| Number Of Male Beneficiaries | 409 |
| Number Of Non Hispanic White Beneficiaries | 653 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 53 |
| Number Of American Indian Alaska Native Beneficiaries | 13 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 555 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 184 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 27 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 43 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 33 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 2.3172 |