| National Provider Identifier [NPI]: | 1437154507 |
| Last Name Of The Provider | CARROLL |
| First Name Of The Provider | JOSIAH |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 855 ILLINI DR |
| Street Address 2 Of The Provider | STE 300 |
| City Of The Provider | SILVIS |
| Zip Code Of The Provider | 612822904 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 53 |
| Number Of Services | 7816 |
| Number Of Medicare Beneficiaries | 1495 |
| Total Submitted Charge Amount | 313709 |
| Total Medicare Allowed Amount | 110160.7 |
| Total Medicare Payment Amount | 81849.11 |
| Total Medicare Standardized Payment Amount | 85422.77 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 128 |
| Number Of Medicare Beneficiaries With Drug Services | 116 |
| Total Drug Submitted ChargeAmount | 4637 |
| Total Drug Medicare AllowedAmount | 3138.11 |
| Total Drug Medicare PaymentAmount | 3029.83 |
| Total Drug Medicare Standardized Payment Amount | 3029.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 7688 |
| Number Of Medicare Beneficiaries With Medical Services | 1495 |
| Total Medical Submitted Charge Amount | 309072 |
| Total Medical Medicare Allowed Amount | 107022.59 |
| Total Medical Medicare Payment Amount | 78819.28 |
| Total Medical Medicare Standardized Payment Amount | 82392.94 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 115 |
| Number Of Beneficiaries Age 65 to 74 | 720 |
| Number Of Beneficiaries Age 75 to 84 | 442 |
| Number Of Beneficiaries Age Greater 84 | 218 |
| Number Of Female Beneficiaries | 747 |
| Number Of Male Beneficiaries | 748 |
| Number Of Non Hispanic White Beneficiaries | 1382 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 41 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 35 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1389 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 106 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 4 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 32 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9788 |