| National Provider Identifier [NPI]: | 1891718177 |
| Last Name Of The Provider | CHARBONNET |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 602 N LEWIS ST |
| Street Address 2 Of The Provider | SUITE 600 |
| City Of The Provider | NEW IBERIA |
| Zip Code Of The Provider | 705632093 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | General Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 69 |
| Number Of Services | 48890 |
| Number Of Medicare Beneficiaries | 305 |
| Total Submitted Charge Amount | 1975442 |
| Total Medicare Allowed Amount | 845095.67 |
| Total Medicare Payment Amount | 642545.9 |
| Total Medicare Standardized Payment Amount | 640957.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 33 |
| Number Of Drug Services | 39267 |
| Number Of Medicare Beneficiaries With Drug Services | 246 |
| Total Drug Submitted ChargeAmount | 1439627 |
| Total Drug Medicare AllowedAmount | 580329.32 |
| Total Drug Medicare PaymentAmount | 442945.37 |
| Total Drug Medicare Standardized Payment Amount | 442945.37 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 36 |
| Number Of Medical Services | 9623 |
| Number Of Medicare Beneficiaries With Medical Services | 305 |
| Total Medical Submitted Charge Amount | 535815 |
| Total Medical Medicare Allowed Amount | 264766.35 |
| Total Medical Medicare Payment Amount | 199600.53 |
| Total Medical Medicare Standardized Payment Amount | 198012.44 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 21 |
| Number Of Beneficiaries Age 65 to 74 | 119 |
| Number Of Beneficiaries Age 75 to 84 | 119 |
| Number Of Beneficiaries Age Greater 84 | 46 |
| Number Of Female Beneficiaries | 230 |
| Number Of Male Beneficiaries | 75 |
| Number Of Non Hispanic White Beneficiaries | 243 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 252 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 53 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 26 |
| Percent Of With Heart Failure | 17 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 45 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.5079 |