| National Provider Identifier [NPI]: | 1821049214 |
| Last Name Of The Provider | CARRERA |
| First Name Of The Provider | GUILLERMO |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | HOSPITAL BASED @ FROEDTERT HOSP. |
| Street Address 2 Of The Provider | 9200 WEST WISCONSIN AVENUE |
| City Of The Provider | MILWAUKEE |
| Zip Code Of The Provider | 53226 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 84 |
| Number Of Services | 4967 |
| Number Of Medicare Beneficiaries | 3308 |
| Total Submitted Charge Amount | 607062.92 |
| Total Medicare Allowed Amount | 58103.74 |
| Total Medicare Payment Amount | 45925.05 |
| Total Medicare Standardized Payment Amount | 48158.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 0 |
| Number Of Drug Services | 0 |
| Number Of Medicare Beneficiaries With Drug Services | 0 |
| Total Drug Submitted ChargeAmount | 0 |
| Total Drug Medicare AllowedAmount | 0 |
| Total Drug Medicare PaymentAmount | 0 |
| Total Drug Medicare Standardized Payment Amount | 0 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 84 |
| Number Of Medical Services | 4967 |
| Number Of Medicare Beneficiaries With Medical Services | 3308 |
| Total Medical Submitted Charge Amount | 607062.92 |
| Total Medical Medicare Allowed Amount | 58103.74 |
| Total Medical Medicare Payment Amount | 45925.05 |
| Total Medical Medicare Standardized Payment Amount | 48158.99 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 824 |
| Number Of Beneficiaries Age 65 to 74 | 1296 |
| Number Of Beneficiaries Age 75 to 84 | 784 |
| Number Of Beneficiaries Age Greater 84 | 404 |
| Number Of Female Beneficiaries | 2236 |
| Number Of Male Beneficiaries | 1072 |
| Number Of Non Hispanic White Beneficiaries | 2492 |
| Number Of Black or African American Beneficiaries | 630 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 94 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 52 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2317 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 991 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 15 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 16 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 30 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 19 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 1.7607 |