| National Provider Identifier [NPI]: | 1598783870 |
| Last Name Of The Provider | PEREZ |
| First Name Of The Provider | CARLOS |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 921 TEXAS BLVD |
| Street Address 2 Of The Provider | STE D |
| City Of The Provider | TEXARKANA |
| Zip Code Of The Provider | 755015163 |
| 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 | 59 |
| Number Of Services | 7673 |
| Number Of Medicare Beneficiaries | 723 |
| Total Submitted Charge Amount | 461478.82 |
| Total Medicare Allowed Amount | 451891.71 |
| Total Medicare Payment Amount | 352244.27 |
| Total Medicare Standardized Payment Amount | 314041.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 1270 |
| Number Of Medicare Beneficiaries With Drug Services | 234 |
| Total Drug Submitted ChargeAmount | 6296.1 |
| Total Drug Medicare AllowedAmount | 6224.75 |
| Total Drug Medicare PaymentAmount | 5704.38 |
| Total Drug Medicare Standardized Payment Amount | 5704.38 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 52 |
| Number Of Medical Services | 6403 |
| Number Of Medicare Beneficiaries With Medical Services | 719 |
| Total Medical Submitted Charge Amount | 455182.72 |
| Total Medical Medicare Allowed Amount | 445666.96 |
| Total Medical Medicare Payment Amount | 346539.89 |
| Total Medical Medicare Standardized Payment Amount | 308336.67 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 153 |
| Number Of Beneficiaries Age 65 to 74 | 270 |
| Number Of Beneficiaries Age 75 to 84 | 209 |
| Number Of Beneficiaries Age Greater 84 | 91 |
| Number Of Female Beneficiaries | 371 |
| Number Of Male Beneficiaries | 352 |
| Number Of Non Hispanic White Beneficiaries | 564 |
| Number Of Black or African American Beneficiaries | 140 |
| 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 | 485 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 238 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 16 |
| Percent Of With Asthma | 17 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 55 |
| Percent Of With Chronic Kidney Disease | 38 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 65 |
| Percent Of With Depression | 24 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 59 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 49 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.935 |