| National Provider Identifier [NPI]: | 1144427055 |
| Last Name Of The Provider | CAROLAN |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 166 4TH ST E |
| Street Address 2 Of The Provider | |
| City Of The Provider | SAINT PAUL |
| Zip Code Of The Provider | 551011421 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 175 |
| Number Of Services | 8443 |
| Number Of Medicare Beneficiaries | 2627 |
| Total Submitted Charge Amount | 765541.34 |
| Total Medicare Allowed Amount | 276074.79 |
| Total Medicare Payment Amount | 208980.9 |
| Total Medicare Standardized Payment Amount | 213828.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 4591 |
| Number Of Medicare Beneficiaries With Drug Services | 44 |
| Total Drug Submitted ChargeAmount | 6529.5 |
| Total Drug Medicare AllowedAmount | 991.84 |
| Total Drug Medicare PaymentAmount | 769.02 |
| Total Drug Medicare Standardized Payment Amount | 769.02 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 173 |
| Number Of Medical Services | 3852 |
| Number Of Medicare Beneficiaries With Medical Services | 2627 |
| Total Medical Submitted Charge Amount | 759011.84 |
| Total Medical Medicare Allowed Amount | 275082.95 |
| Total Medical Medicare Payment Amount | 208211.88 |
| Total Medical Medicare Standardized Payment Amount | 213059.89 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 662 |
| Number Of Beneficiaries Age 65 to 74 | 828 |
| Number Of Beneficiaries Age 75 to 84 | 699 |
| Number Of Beneficiaries Age Greater 84 | 438 |
| Number Of Female Beneficiaries | 1505 |
| Number Of Male Beneficiaries | 1122 |
| Number Of Non Hispanic White Beneficiaries | 2291 |
| Number Of Black or African American Beneficiaries | 175 |
| Number Of AsianPacific Islander Beneficiaries | 43 |
| Number Of Hispanic Beneficiaries | 70 |
| Number Of American Indian Alaska Native Beneficiaries | 12 |
| Number Of Beneficiaries With Race Not Else where Classified | 36 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1882 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 745 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 19 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 67 |
| Percent Of With Ischemic Heart Disease | 39 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.6864 |