| National Provider Identifier [NPI]: | 1316965114 |
| Last Name Of The Provider | ANDERSON |
| First Name Of The Provider | CARMEN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1350 HICKORY STREET |
| Street Address 2 Of The Provider | |
| City Of The Provider | MELBOURNE |
| Zip Code Of The Provider | 329013224 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 88 |
| Number Of Services | 3271 |
| Number Of Medicare Beneficiaries | 2208 |
| Total Submitted Charge Amount | 289027 |
| Total Medicare Allowed Amount | 96781.59 |
| Total Medicare Payment Amount | 74473.59 |
| Total Medicare Standardized Payment Amount | 76171.29 |
| 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 | 88 |
| Number Of Medical Services | 3271 |
| Number Of Medicare Beneficiaries With Medical Services | 2208 |
| Total Medical Submitted Charge Amount | 289027 |
| Total Medical Medicare Allowed Amount | 96781.59 |
| Total Medical Medicare Payment Amount | 74473.59 |
| Total Medical Medicare Standardized Payment Amount | 76171.29 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 418 |
| Number Of Beneficiaries Age 65 to 74 | 596 |
| Number Of Beneficiaries Age 75 to 84 | 685 |
| Number Of Beneficiaries Age Greater 84 | 509 |
| Number Of Female Beneficiaries | 1217 |
| Number Of Male Beneficiaries | 991 |
| Number Of Non Hispanic White Beneficiaries | 1875 |
| Number Of Black or African American Beneficiaries | 171 |
| Number Of AsianPacific Islander Beneficiaries | 23 |
| Number Of Hispanic Beneficiaries | 115 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1646 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 562 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 32 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 72 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 14 |
| Average HCC Risk Score Of Beneficiaries | 1.9706 |