| National Provider Identifier [NPI]: | 1346230596 |
| Last Name Of The Provider | OLLIVIERRE |
| First Name Of The Provider | CARL |
| Middle Initial Of The Provider | O |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 600 NORTH BLVD W |
| Street Address 2 Of The Provider | SUITE C |
| City Of The Provider | LEESBURG |
| Zip Code Of The Provider | 347485063 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 4853 |
| Number Of Medicare Beneficiaries | 1048 |
| Total Submitted Charge Amount | 979798.13 |
| Total Medicare Allowed Amount | 458647.94 |
| Total Medicare Payment Amount | 341723.16 |
| Total Medicare Standardized Payment Amount | 336909.91 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 870 |
| Number Of Medicare Beneficiaries With Drug Services | 260 |
| Total Drug Submitted ChargeAmount | 19869.13 |
| Total Drug Medicare AllowedAmount | 9899.89 |
| Total Drug Medicare PaymentAmount | 7559.5 |
| Total Drug Medicare Standardized Payment Amount | 7559.5 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 109 |
| Number Of Medical Services | 3983 |
| Number Of Medicare Beneficiaries With Medical Services | 1048 |
| Total Medical Submitted Charge Amount | 959929 |
| Total Medical Medicare Allowed Amount | 448748.05 |
| Total Medical Medicare Payment Amount | 334163.66 |
| Total Medical Medicare Standardized Payment Amount | 329350.41 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 44 |
| Number Of Beneficiaries Age 65 to 74 | 478 |
| Number Of Beneficiaries Age 75 to 84 | 381 |
| Number Of Beneficiaries Age Greater 84 | 145 |
| Number Of Female Beneficiaries | 618 |
| Number Of Male Beneficiaries | 430 |
| Number Of Non Hispanic White Beneficiaries | 988 |
| Number Of Black or African American Beneficiaries | 36 |
| 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 | 993 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 55 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 29 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 47 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 71 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.1643 |