| National Provider Identifier [NPI]: | 1063482404 |
| Last Name Of The Provider | ELLIOTT |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1009 CITY AVE N |
| Street Address 2 Of The Provider | SUITE A |
| City Of The Provider | RIPLEY |
| Zip Code Of The Provider | 386631414 |
| State Code Of The Provider | MS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 9183 |
| Number Of Medicare Beneficiaries | 1137 |
| Total Submitted Charge Amount | 505899 |
| Total Medicare Allowed Amount | 328893.49 |
| Total Medicare Payment Amount | 226450.38 |
| Total Medicare Standardized Payment Amount | 248393.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 1177 |
| Number Of Medicare Beneficiaries With Drug Services | 528 |
| Total Drug Submitted ChargeAmount | 23980 |
| Total Drug Medicare AllowedAmount | 7216.72 |
| Total Drug Medicare PaymentAmount | 6375.76 |
| Total Drug Medicare Standardized Payment Amount | 6375.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 73 |
| Number Of Medical Services | 8006 |
| Number Of Medicare Beneficiaries With Medical Services | 1137 |
| Total Medical Submitted Charge Amount | 481919 |
| Total Medical Medicare Allowed Amount | 321676.77 |
| Total Medical Medicare Payment Amount | 220074.62 |
| Total Medical Medicare Standardized Payment Amount | 242017.42 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 239 |
| Number Of Beneficiaries Age 65 to 74 | 402 |
| Number Of Beneficiaries Age 75 to 84 | 325 |
| Number Of Beneficiaries Age Greater 84 | 171 |
| Number Of Female Beneficiaries | 641 |
| Number Of Male Beneficiaries | 496 |
| Number Of Non Hispanic White Beneficiaries | 986 |
| Number Of Black or African American Beneficiaries | 140 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 682 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 455 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 24 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 47 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.271 |