| National Provider Identifier [NPI]: | 1093860678 |
| Last Name Of The Provider | CHARLES |
| First Name Of The Provider | ANA |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 180 PATRICIA AVE |
| Street Address 2 Of The Provider | |
| City Of The Provider | DUNEDIN |
| Zip Code Of The Provider | 346988103 |
| 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 | 57 |
| Number Of Services | 1489 |
| Number Of Medicare Beneficiaries | 298 |
| Total Submitted Charge Amount | 164738 |
| Total Medicare Allowed Amount | 96445.67 |
| Total Medicare Payment Amount | 70729.38 |
| Total Medicare Standardized Payment Amount | 71820.32 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 13 |
| Number Of Drug Services | 145 |
| Number Of Medicare Beneficiaries With Drug Services | 120 |
| Total Drug Submitted ChargeAmount | 5837 |
| Total Drug Medicare AllowedAmount | 2866.44 |
| Total Drug Medicare PaymentAmount | 2782.28 |
| Total Drug Medicare Standardized Payment Amount | 2782.28 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 1344 |
| Number Of Medicare Beneficiaries With Medical Services | 298 |
| Total Medical Submitted Charge Amount | 158901 |
| Total Medical Medicare Allowed Amount | 93579.23 |
| Total Medical Medicare Payment Amount | 67947.1 |
| Total Medical Medicare Standardized Payment Amount | 69038.04 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 33 |
| Number Of Beneficiaries Age 65 to 74 | 132 |
| Number Of Beneficiaries Age 75 to 84 | 81 |
| Number Of Beneficiaries Age Greater 84 | 52 |
| Number Of Female Beneficiaries | 224 |
| Number Of Male Beneficiaries | 74 |
| Number Of Non Hispanic White Beneficiaries | 264 |
| Number Of Black or African American Beneficiaries | 15 |
| 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 | 259 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 39 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 17 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 63 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 26 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9513 |