| National Provider Identifier [NPI]: | 1376543264 |
| Last Name Of The Provider | BORRELL |
| First Name Of The Provider | CHARLES |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5002 COWHORN CREEK RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TEXARKANA |
| Zip Code Of The Provider | 755039766 |
| State Code Of The Provider | TX |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 152 |
| Number Of Services | 55025 |
| Number Of Medicare Beneficiaries | 3568 |
| Total Submitted Charge Amount | 2461772.55 |
| Total Medicare Allowed Amount | 625867.94 |
| Total Medicare Payment Amount | 481767.1 |
| Total Medicare Standardized Payment Amount | 528299.73 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 49104 |
| Number Of Medicare Beneficiaries With Drug Services | 644 |
| Total Drug Submitted ChargeAmount | 139445.1 |
| Total Drug Medicare AllowedAmount | 18765.12 |
| Total Drug Medicare PaymentAmount | 14365.63 |
| Total Drug Medicare Standardized Payment Amount | 14365.63 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 146 |
| Number Of Medical Services | 5921 |
| Number Of Medicare Beneficiaries With Medical Services | 3567 |
| Total Medical Submitted Charge Amount | 2322327.45 |
| Total Medical Medicare Allowed Amount | 607102.82 |
| Total Medical Medicare Payment Amount | 467401.47 |
| Total Medical Medicare Standardized Payment Amount | 513934.1 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 406 |
| Number Of Beneficiaries Age 65 to 74 | 1660 |
| Number Of Beneficiaries Age 75 to 84 | 1158 |
| Number Of Beneficiaries Age Greater 84 | 344 |
| Number Of Female Beneficiaries | 2410 |
| Number Of Male Beneficiaries | 1158 |
| Number Of Non Hispanic White Beneficiaries | 3056 |
| Number Of Black or African American Beneficiaries | 446 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 3120 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 448 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.1546 |