| National Provider Identifier [NPI]: | 1952305518 |
| Last Name Of The Provider | HAGEN |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 WHITESPORT CIR SW |
| Street Address 2 Of The Provider | |
| City Of The Provider | HUNTSVILLE |
| Zip Code Of The Provider | 358016495 |
| State Code Of The Provider | AL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 25 |
| Number Of Services | 860 |
| Number Of Medicare Beneficiaries | 603 |
| Total Submitted Charge Amount | 665197 |
| Total Medicare Allowed Amount | 92035.46 |
| Total Medicare Payment Amount | 70646.3 |
| Total Medicare Standardized Payment Amount | 74707.27 |
| 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 | 25 |
| Number Of Medical Services | 860 |
| Number Of Medicare Beneficiaries With Medical Services | 603 |
| Total Medical Submitted Charge Amount | 665197 |
| Total Medical Medicare Allowed Amount | 92035.46 |
| Total Medical Medicare Payment Amount | 70646.3 |
| Total Medical Medicare Standardized Payment Amount | 74707.27 |
| Average Age Of Beneficiaries | 65 |
| Number Of Beneficiaries Age Less65 | 259 |
| Number Of Beneficiaries Age 65 to 74 | 167 |
| Number Of Beneficiaries Age 75 to 84 | 109 |
| Number Of Beneficiaries Age Greater 84 | 68 |
| Number Of Female Beneficiaries | 355 |
| Number Of Male Beneficiaries | 248 |
| Number Of Non Hispanic White Beneficiaries | 476 |
| Number Of Black or African American Beneficiaries | |
| 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 | 322 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 281 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.506 |