| National Provider Identifier [NPI]: | 1871507228 |
| Last Name Of The Provider | CARSON |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | G |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 10535 HOSPITAL WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | MATHER |
| Zip Code Of The Provider | 956554200 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Vascular Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 52 |
| Number Of Services | 997 |
| Number Of Medicare Beneficiaries | 650 |
| Total Submitted Charge Amount | 164878 |
| Total Medicare Allowed Amount | 42857.98 |
| Total Medicare Payment Amount | 32528.76 |
| Total Medicare Standardized Payment Amount | 32248.14 |
| 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 | 52 |
| Number Of Medical Services | 997 |
| Number Of Medicare Beneficiaries With Medical Services | 650 |
| Total Medical Submitted Charge Amount | 164878 |
| Total Medical Medicare Allowed Amount | 42857.98 |
| Total Medical Medicare Payment Amount | 32528.76 |
| Total Medical Medicare Standardized Payment Amount | 32248.14 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 125 |
| Number Of Beneficiaries Age 65 to 74 | 260 |
| Number Of Beneficiaries Age 75 to 84 | 192 |
| Number Of Beneficiaries Age Greater 84 | 73 |
| Number Of Female Beneficiaries | 336 |
| Number Of Male Beneficiaries | 314 |
| Number Of Non Hispanic White Beneficiaries | 444 |
| Number Of Black or African American Beneficiaries | 80 |
| Number Of AsianPacific Islander Beneficiaries | 36 |
| Number Of Hispanic Beneficiaries | 74 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 409 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 241 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 11 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 35 |
| Percent Of With Chronic Kidney Disease | 44 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 26 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.1918 |