| National Provider Identifier [NPI]: | 1164544045 |
| Last Name Of The Provider | CARLSON |
| First Name Of The Provider | CHESTER |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | D.O. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5212 VILLAGE PKWY |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROGERS |
| Zip Code Of The Provider | 727588104 |
| State Code Of The Provider | AR |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 133 |
| Number Of Services | 28966 |
| Number Of Medicare Beneficiaries | 1230 |
| Total Submitted Charge Amount | 3910168.27 |
| Total Medicare Allowed Amount | 1482066.2 |
| Total Medicare Payment Amount | 1134403.58 |
| Total Medicare Standardized Payment Amount | 1236649.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 11 |
| Number Of Drug Services | 1970 |
| Number Of Medicare Beneficiaries With Drug Services | 375 |
| Total Drug Submitted ChargeAmount | 193177 |
| Total Drug Medicare AllowedAmount | 95355.76 |
| Total Drug Medicare PaymentAmount | 74655.86 |
| Total Drug Medicare Standardized Payment Amount | 74655.86 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 122 |
| Number Of Medical Services | 26996 |
| Number Of Medicare Beneficiaries With Medical Services | 1230 |
| Total Medical Submitted Charge Amount | 3716991.27 |
| Total Medical Medicare Allowed Amount | 1386710.44 |
| Total Medical Medicare Payment Amount | 1059747.72 |
| Total Medical Medicare Standardized Payment Amount | 1161993.62 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 196 |
| Number Of Beneficiaries Age 65 to 74 | 505 |
| Number Of Beneficiaries Age 75 to 84 | 382 |
| Number Of Beneficiaries Age Greater 84 | 147 |
| Number Of Female Beneficiaries | 626 |
| Number Of Male Beneficiaries | 604 |
| Number Of Non Hispanic White Beneficiaries | 1090 |
| Number Of Black or African American Beneficiaries | 98 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 17 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1053 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 177 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 9 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 14 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 53 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 59 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.2419 |