| National Provider Identifier [NPI]: | 1447227954 |
| Last Name Of The Provider | GIMENEZ |
| First Name Of The Provider | CARLOS |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 602 N ACADIA RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | THIBODAUX |
| Zip Code Of The Provider | 703014847 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 176 |
| Number Of Services | 7359 |
| Number Of Medicare Beneficiaries | 3423 |
| Total Submitted Charge Amount | 827791 |
| Total Medicare Allowed Amount | 204047.74 |
| Total Medicare Payment Amount | 152251.35 |
| Total Medicare Standardized Payment Amount | 165474.08 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 176 |
| Number Of Medical Services | 7359 |
| Number Of Medicare Beneficiaries With Medical Services | 3423 |
| Total Medical Submitted Charge Amount | 827791 |
| Total Medical Medicare Allowed Amount | 204047.74 |
| Total Medical Medicare Payment Amount | 152251.35 |
| Total Medical Medicare Standardized Payment Amount | 165474.08 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 760 |
| Number Of Beneficiaries Age 65 to 74 | 1327 |
| Number Of Beneficiaries Age 75 to 84 | 960 |
| Number Of Beneficiaries Age Greater 84 | 376 |
| Number Of Female Beneficiaries | 2095 |
| Number Of Male Beneficiaries | 1328 |
| Number Of Non Hispanic White Beneficiaries | 2585 |
| Number Of Black or African American Beneficiaries | 716 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 86 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 19 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2282 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1141 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 15 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 6 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.5669 |