| National Provider Identifier [NPI]: | 1770587420 |
| Last Name Of The Provider | CHARBONNEAU |
| First Name Of The Provider | EUGENE |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 110 NE 5TH STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | CARRABELLE |
| Zip Code Of The Provider | 323223529 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 65 |
| Number Of Services | 1562 |
| Number Of Medicare Beneficiaries | 419 |
| Total Submitted Charge Amount | 147572 |
| Total Medicare Allowed Amount | 95128.71 |
| Total Medicare Payment Amount | 63510.88 |
| Total Medicare Standardized Payment Amount | 66953.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 14 |
| Number Of Drug Services | 199 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 3376 |
| Total Drug Medicare AllowedAmount | 1100.95 |
| Total Drug Medicare PaymentAmount | 1046.3 |
| Total Drug Medicare Standardized Payment Amount | 1046.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 51 |
| Number Of Medical Services | 1363 |
| Number Of Medicare Beneficiaries With Medical Services | 417 |
| Total Medical Submitted Charge Amount | 144196 |
| Total Medical Medicare Allowed Amount | 94027.76 |
| Total Medical Medicare Payment Amount | 62464.58 |
| Total Medical Medicare Standardized Payment Amount | 65907.66 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 64 |
| Number Of Beneficiaries Age 65 to 74 | 190 |
| Number Of Beneficiaries Age 75 to 84 | 113 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 226 |
| Number Of Male Beneficiaries | 193 |
| Number Of Non Hispanic White Beneficiaries | 401 |
| Number Of Black or African American Beneficiaries | |
| 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 | 315 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 104 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 41 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 37 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 1.0901 |