| National Provider Identifier [NPI]: | 1235128620 |
| Last Name Of The Provider | CARBONELL |
| First Name Of The Provider | OSCAR |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1673 MASON AVE |
| Street Address 2 Of The Provider | 305 |
| City Of The Provider | DAYTONA BEACH |
| Zip Code Of The Provider | 321175515 |
| 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 | 254 |
| Number Of Services | 33810 |
| Number Of Medicare Beneficiaries | 2078 |
| Total Submitted Charge Amount | 1462125.01 |
| Total Medicare Allowed Amount | 383096.1 |
| Total Medicare Payment Amount | 291441.18 |
| Total Medicare Standardized Payment Amount | 299138.41 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 30766 |
| Number Of Medicare Beneficiaries With Drug Services | 396 |
| Total Drug Submitted ChargeAmount | 42362.93 |
| Total Drug Medicare AllowedAmount | 8521.59 |
| Total Drug Medicare PaymentAmount | 6555.78 |
| Total Drug Medicare Standardized Payment Amount | 6555.78 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 249 |
| Number Of Medical Services | 3044 |
| Number Of Medicare Beneficiaries With Medical Services | 2072 |
| Total Medical Submitted Charge Amount | 1419762.08 |
| Total Medical Medicare Allowed Amount | 374574.51 |
| Total Medical Medicare Payment Amount | 284885.4 |
| Total Medical Medicare Standardized Payment Amount | 292582.63 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 351 |
| Number Of Beneficiaries Age 65 to 74 | 794 |
| Number Of Beneficiaries Age 75 to 84 | 635 |
| Number Of Beneficiaries Age Greater 84 | 298 |
| Number Of Female Beneficiaries | 1186 |
| Number Of Male Beneficiaries | 892 |
| Number Of Non Hispanic White Beneficiaries | 1826 |
| Number Of Black or African American Beneficiaries | 163 |
| Number Of AsianPacific Islander Beneficiaries | 17 |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1695 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 383 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 35 |
| Percent Of With Hyperlipidemia | 70 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.5129 |