| National Provider Identifier [NPI]: | 1326008368 |
| Last Name Of The Provider | CARLSON |
| First Name Of The Provider | CHAD |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 6000 UNIVERSITY AVE |
| Street Address 2 Of The Provider | SUITE 250 |
| City Of The Provider | WEST DES MOINES |
| Zip Code Of The Provider | 502668203 |
| State Code Of The Provider | IA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 657 |
| Number Of Medicare Beneficiaries | 66 |
| Total Submitted Charge Amount | 57802 |
| Total Medicare Allowed Amount | 30832.43 |
| Total Medicare Payment Amount | 22870.75 |
| Total Medicare Standardized Payment Amount | 24095.43 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 330 |
| Number Of Medicare Beneficiaries With Drug Services | 31 |
| Total Drug Submitted ChargeAmount | 3512 |
| Total Drug Medicare AllowedAmount | 2314.26 |
| Total Drug Medicare PaymentAmount | 1814.4 |
| Total Drug Medicare Standardized Payment Amount | 1814.4 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 21 |
| Number Of Medical Services | 327 |
| Number Of Medicare Beneficiaries With Medical Services | 66 |
| Total Medical Submitted Charge Amount | 54290 |
| Total Medical Medicare Allowed Amount | 28518.17 |
| Total Medical Medicare Payment Amount | 21056.35 |
| Total Medical Medicare Standardized Payment Amount | 22281.03 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | |
| Number Of Beneficiaries Age 65 to 74 | 37 |
| Number Of Beneficiaries Age 75 to 84 | |
| Number Of Beneficiaries Age Greater 84 | |
| Number Of Female Beneficiaries | 41 |
| Number Of Male Beneficiaries | 25 |
| Number Of Non Hispanic White Beneficiaries | |
| Number Of Black or African American Beneficiaries | |
| 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 | |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | |
| Percent Of With Atrial Fibrillation | |
| Percent Of With Alzheimers Disease or Dementia | |
| Percent Of With Asthma | |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | |
| Percent Of With Chronic Kidney Disease | |
| Percent Of With Chronic Obstructive Pulmonary Disease | |
| Percent Of With Depression | 27 |
| Percent Of With Diabetes | |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 41 |
| Percent Of With Ischemic Heart Disease | 17 |
| Percent Of With Osteoporosis | |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 0.7566 |