| National Provider Identifier [NPI]: | 1215924329 |
| Last Name Of The Provider | CARLSON |
| First Name Of The Provider | GREGORY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1120 W. LA VETA AVENUE |
| Street Address 2 Of The Provider | SUITE 300 |
| City Of The Provider | ORANGE |
| Zip Code Of The Provider | 928684246 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 113 |
| Number Of Services | 5679 |
| Number Of Medicare Beneficiaries | 715 |
| Total Submitted Charge Amount | 3571896 |
| Total Medicare Allowed Amount | 1085945.53 |
| Total Medicare Payment Amount | 839810.37 |
| Total Medicare Standardized Payment Amount | 690969.04 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 300 |
| Number Of Medicare Beneficiaries With Drug Services | 63 |
| Total Drug Submitted ChargeAmount | 3750 |
| Total Drug Medicare AllowedAmount | 1430.46 |
| Total Drug Medicare PaymentAmount | 1055.59 |
| Total Drug Medicare Standardized Payment Amount | 1055.59 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 111 |
| Number Of Medical Services | 5379 |
| Number Of Medicare Beneficiaries With Medical Services | 715 |
| Total Medical Submitted Charge Amount | 3568146 |
| Total Medical Medicare Allowed Amount | 1084515.07 |
| Total Medical Medicare Payment Amount | 838754.78 |
| Total Medical Medicare Standardized Payment Amount | 689913.45 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 59 |
| Number Of Beneficiaries Age 65 to 74 | 311 |
| Number Of Beneficiaries Age 75 to 84 | 272 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 424 |
| Number Of Male Beneficiaries | 291 |
| Number Of Non Hispanic White Beneficiaries | 586 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 42 |
| Number Of Hispanic Beneficiaries | 63 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 629 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 86 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 21 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 40 |
| Percent Of With Osteoporosis | 16 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.2067 |