| National Provider Identifier [NPI]: | 1376596130 |
| Last Name Of The Provider | DAHLBERG |
| First Name Of The Provider | CARL |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6624 FANNIN ST |
| Street Address 2 Of The Provider | SUITE 1730 |
| City Of The Provider | HOUSTON |
| Zip Code Of The Provider | 770302312 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 48 |
| Number Of Services | 10105 |
| Number Of Medicare Beneficiaries | 1379 |
| Total Submitted Charge Amount | 1529706.86 |
| Total Medicare Allowed Amount | 643132.67 |
| Total Medicare Payment Amount | 490310.27 |
| Total Medicare Standardized Payment Amount | 494759.61 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 2161 |
| Number Of Medicare Beneficiaries With Drug Services | 219 |
| Total Drug Submitted ChargeAmount | 35482.86 |
| Total Drug Medicare AllowedAmount | 18364.66 |
| Total Drug Medicare PaymentAmount | 14973.23 |
| Total Drug Medicare Standardized Payment Amount | 14973.23 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 43 |
| Number Of Medical Services | 7944 |
| Number Of Medicare Beneficiaries With Medical Services | 1379 |
| Total Medical Submitted Charge Amount | 1494224 |
| Total Medical Medicare Allowed Amount | 624768.01 |
| Total Medical Medicare Payment Amount | 475337.04 |
| Total Medical Medicare Standardized Payment Amount | 479786.38 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 185 |
| Number Of Beneficiaries Age 65 to 74 | 556 |
| Number Of Beneficiaries Age 75 to 84 | 429 |
| Number Of Beneficiaries Age Greater 84 | 209 |
| Number Of Female Beneficiaries | 750 |
| Number Of Male Beneficiaries | 629 |
| Number Of Non Hispanic White Beneficiaries | 1017 |
| Number Of Black or African American Beneficiaries | 215 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 112 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1172 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 207 |
| Percent Of With Atrial Fibrillation | 32 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 25 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 56 |
| Percent Of With Chronic Kidney Disease | 53 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 55 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 69 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.5908 |