| National Provider Identifier [NPI]: | 1518029347 |
| Last Name Of The Provider | CARLSON |
| First Name Of The Provider | JEFFREY |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 250 NAT TURNER BLVD S |
| Street Address 2 Of The Provider | |
| City Of The Provider | NEWPORT NEWS |
| Zip Code Of The Provider | 236062899 |
| State Code Of The Provider | VA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 155 |
| Number Of Services | 15300 |
| Number Of Medicare Beneficiaries | 1639 |
| Total Submitted Charge Amount | 6200810 |
| Total Medicare Allowed Amount | 1470566.18 |
| Total Medicare Payment Amount | 1119006.46 |
| Total Medicare Standardized Payment Amount | 1082553.29 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 2828 |
| Number Of Medicare Beneficiaries With Drug Services | 888 |
| Total Drug Submitted ChargeAmount | 281574 |
| Total Drug Medicare AllowedAmount | 67845.55 |
| Total Drug Medicare PaymentAmount | 52976.61 |
| Total Drug Medicare Standardized Payment Amount | 52976.61 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 149 |
| Number Of Medical Services | 12472 |
| Number Of Medicare Beneficiaries With Medical Services | 1639 |
| Total Medical Submitted Charge Amount | 5919236 |
| Total Medical Medicare Allowed Amount | 1402720.63 |
| Total Medical Medicare Payment Amount | 1066029.85 |
| Total Medical Medicare Standardized Payment Amount | 1029576.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 183 |
| Number Of Beneficiaries Age 65 to 74 | 769 |
| Number Of Beneficiaries Age 75 to 84 | 550 |
| Number Of Beneficiaries Age Greater 84 | 137 |
| Number Of Female Beneficiaries | 1096 |
| Number Of Male Beneficiaries | 543 |
| Number Of Non Hispanic White Beneficiaries | 1278 |
| Number Of Black or African American Beneficiaries | 301 |
| Number Of AsianPacific Islander Beneficiaries | 18 |
| Number Of Hispanic Beneficiaries | 22 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1499 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 140 |
| Percent Of With Atrial Fibrillation | 9 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 18 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 60 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0326 |