| National Provider Identifier [NPI]: | 1992975791 |
| Last Name Of The Provider | CARLSON |
| First Name Of The Provider | BRETT |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 400 E 3RD ST |
| Street Address 2 Of The Provider | ESSENTIA HEALTH DULUTH CLINIC |
| City Of The Provider | DULUTH |
| Zip Code Of The Provider | 558051951 |
| State Code Of The Provider | MN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 50 |
| Number Of Services | 1638 |
| Number Of Medicare Beneficiaries | 543 |
| Total Submitted Charge Amount | 257959.5 |
| Total Medicare Allowed Amount | 66527.36 |
| Total Medicare Payment Amount | 49179.94 |
| Total Medicare Standardized Payment Amount | 50293.97 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 573 |
| Number Of Medicare Beneficiaries With Drug Services | 17 |
| Total Drug Submitted ChargeAmount | 10515.5 |
| Total Drug Medicare AllowedAmount | 1419.86 |
| Total Drug Medicare PaymentAmount | 789.3 |
| Total Drug Medicare Standardized Payment Amount | 789.3 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 46 |
| Number Of Medical Services | 1065 |
| Number Of Medicare Beneficiaries With Medical Services | 540 |
| Total Medical Submitted Charge Amount | 247444 |
| Total Medical Medicare Allowed Amount | 65107.5 |
| Total Medical Medicare Payment Amount | 48390.64 |
| Total Medical Medicare Standardized Payment Amount | 49504.67 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 100 |
| Number Of Beneficiaries Age 65 to 74 | 180 |
| Number Of Beneficiaries Age 75 to 84 | 173 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 273 |
| Number Of Male Beneficiaries | 270 |
| Number Of Non Hispanic White Beneficiaries | 476 |
| Number Of Black or African American Beneficiaries | 46 |
| 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 | 393 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 150 |
| Percent Of With Atrial Fibrillation | 31 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 62 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.8317 |