| National Provider Identifier [NPI]: | 1841223039 |
| Last Name Of The Provider | BALEEIRO |
| First Name Of The Provider | CARLOS |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 725 GLENWOOD DR |
| Street Address 2 Of The Provider | SUITE E-500 |
| City Of The Provider | CHATTANOOGA |
| Zip Code Of The Provider | 374041163 |
| State Code Of The Provider | TN |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Pulmonary Disease |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 62 |
| Number Of Services | 5981 |
| Number Of Medicare Beneficiaries | 760 |
| Total Submitted Charge Amount | 655392 |
| Total Medicare Allowed Amount | 367268.24 |
| Total Medicare Payment Amount | 285216.08 |
| Total Medicare Standardized Payment Amount | 299534.96 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 57 |
| Number Of Medicare Beneficiaries With Drug Services | 50 |
| Total Drug Submitted ChargeAmount | 2837 |
| Total Drug Medicare AllowedAmount | 1556.39 |
| Total Drug Medicare PaymentAmount | 1525.16 |
| Total Drug Medicare Standardized Payment Amount | 1525.16 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 60 |
| Number Of Medical Services | 5924 |
| Number Of Medicare Beneficiaries With Medical Services | 760 |
| Total Medical Submitted Charge Amount | 652555 |
| Total Medical Medicare Allowed Amount | 365711.85 |
| Total Medical Medicare Payment Amount | 283690.92 |
| Total Medical Medicare Standardized Payment Amount | 298009.8 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 136 |
| Number Of Beneficiaries Age 65 to 74 | 306 |
| Number Of Beneficiaries Age 75 to 84 | 233 |
| Number Of Beneficiaries Age Greater 84 | 85 |
| Number Of Female Beneficiaries | 417 |
| Number Of Male Beneficiaries | 343 |
| Number Of Non Hispanic White Beneficiaries | 691 |
| Number Of Black or African American Beneficiaries | 53 |
| 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 | 541 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 219 |
| Percent Of With Atrial Fibrillation | 28 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 21 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 52 |
| Percent Of With Chronic Kidney Disease | 47 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 59 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.3771 |