| National Provider Identifier [NPI]: | 1790748531 |
| Last Name Of The Provider | CARNES |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | PHD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2201 CENTRAL AVENUE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ST. PETERSBURG |
| Zip Code Of The Provider | 337138844 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Psychologist (billing independently) |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 8 |
| Number Of Services | 1194 |
| Number Of Medicare Beneficiaries | 287 |
| Total Submitted Charge Amount | 152720 |
| Total Medicare Allowed Amount | 106914.78 |
| Total Medicare Payment Amount | 79437.83 |
| Total Medicare Standardized Payment Amount | 79559.98 |
| 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 | 8 |
| Number Of Medical Services | 1194 |
| Number Of Medicare Beneficiaries With Medical Services | 287 |
| Total Medical Submitted Charge Amount | 152720 |
| Total Medical Medicare Allowed Amount | 106914.78 |
| Total Medical Medicare Payment Amount | 79437.83 |
| Total Medical Medicare Standardized Payment Amount | 79559.98 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 13 |
| Number Of Beneficiaries Age 65 to 74 | 52 |
| Number Of Beneficiaries Age 75 to 84 | 82 |
| Number Of Beneficiaries Age Greater 84 | 140 |
| Number Of Female Beneficiaries | 188 |
| Number Of Male Beneficiaries | 99 |
| Number Of Non Hispanic White Beneficiaries | 268 |
| 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 | 210 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 77 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 61 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 67 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0588 |