| National Provider Identifier [NPI]: | 1922057959 |
| Last Name Of The Provider | ANDERSON |
| First Name Of The Provider | CARLA |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1750 NORTH HAMPTON ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | DESOTO |
| Zip Code Of The Provider | 75115 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 159 |
| Number Of Services | 4901 |
| Number Of Medicare Beneficiaries | 2906 |
| Total Submitted Charge Amount | 594382 |
| Total Medicare Allowed Amount | 134837.34 |
| Total Medicare Payment Amount | 101730.3 |
| Total Medicare Standardized Payment Amount | 103121.37 |
| 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 | 159 |
| Number Of Medical Services | 4901 |
| Number Of Medicare Beneficiaries With Medical Services | 2906 |
| Total Medical Submitted Charge Amount | 594382 |
| Total Medical Medicare Allowed Amount | 134837.34 |
| Total Medical Medicare Payment Amount | 101730.3 |
| Total Medical Medicare Standardized Payment Amount | 103121.37 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 807 |
| Number Of Beneficiaries Age 65 to 74 | 975 |
| Number Of Beneficiaries Age 75 to 84 | 727 |
| Number Of Beneficiaries Age Greater 84 | 397 |
| Number Of Female Beneficiaries | 1754 |
| Number Of Male Beneficiaries | 1152 |
| Number Of Non Hispanic White Beneficiaries | 1127 |
| Number Of Black or African American Beneficiaries | 1419 |
| Number Of AsianPacific Islander Beneficiaries | 16 |
| Number Of Hispanic Beneficiaries | 309 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1659 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1247 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 18 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 54 |
| Percent Of With Hyperlipidemia | 69 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 54 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.7123 |