| National Provider Identifier [NPI]: | 1689671190 |
| Last Name Of The Provider | ANGELES |
| First Name Of The Provider | CARMICHAEL |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2500 ROUTE 347 |
| Street Address 2 Of The Provider | BLDG 14A |
| City Of The Provider | STONY BROOK |
| Zip Code Of The Provider | 117902554 |
| State Code Of The Provider | NY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Nephrology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 26 |
| Number Of Services | 3560 |
| Number Of Medicare Beneficiaries | 668 |
| Total Submitted Charge Amount | 575070 |
| Total Medicare Allowed Amount | 352418.48 |
| Total Medicare Payment Amount | 269608.06 |
| Total Medicare Standardized Payment Amount | 239661.93 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1270 |
| Number Of Medicare Beneficiaries With Drug Services | 26 |
| Total Drug Submitted ChargeAmount | 25400 |
| Total Drug Medicare AllowedAmount | 14596.58 |
| Total Drug Medicare PaymentAmount | 11389.76 |
| Total Drug Medicare Standardized Payment Amount | 11389.76 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 25 |
| Number Of Medical Services | 2290 |
| Number Of Medicare Beneficiaries With Medical Services | 668 |
| Total Medical Submitted Charge Amount | 549670 |
| Total Medical Medicare Allowed Amount | 337821.9 |
| Total Medical Medicare Payment Amount | 258218.3 |
| Total Medical Medicare Standardized Payment Amount | 228272.17 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 85 |
| Number Of Beneficiaries Age 65 to 74 | 195 |
| Number Of Beneficiaries Age 75 to 84 | 207 |
| Number Of Beneficiaries Age Greater 84 | 181 |
| Number Of Female Beneficiaries | 315 |
| Number Of Male Beneficiaries | 353 |
| Number Of Non Hispanic White Beneficiaries | 589 |
| Number Of Black or African American Beneficiaries | 26 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 32 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 506 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 162 |
| Percent Of With Atrial Fibrillation | 30 |
| Percent Of With Alzheimers Disease or Dementia | 26 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 55 |
| Percent Of With Chronic Kidney Disease | 75 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 63 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 42 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 3.5383 |