| National Provider Identifier [NPI]: | 1326046558 |
| Last Name Of The Provider | CARPENTER |
| First Name Of The Provider | CRAIG |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 380 N 200 W |
| Street Address 2 Of The Provider | SUITE 209 |
| City Of The Provider | BOUNTIFUL |
| Zip Code Of The Provider | 840107079 |
| State Code Of The Provider | UT |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 154 |
| Number Of Services | 3639 |
| Number Of Medicare Beneficiaries | 1742 |
| Total Submitted Charge Amount | 262081.18 |
| Total Medicare Allowed Amount | 91368.21 |
| Total Medicare Payment Amount | 65144.14 |
| Total Medicare Standardized Payment Amount | 68367.42 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 1151 |
| Number Of Medicare Beneficiaries With Drug Services | 13 |
| Total Drug Submitted ChargeAmount | 1070.43 |
| Total Drug Medicare AllowedAmount | 198.37 |
| Total Drug Medicare PaymentAmount | 143.96 |
| Total Drug Medicare Standardized Payment Amount | 143.96 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 153 |
| Number Of Medical Services | 2488 |
| Number Of Medicare Beneficiaries With Medical Services | 1742 |
| Total Medical Submitted Charge Amount | 261010.75 |
| Total Medical Medicare Allowed Amount | 91169.84 |
| Total Medical Medicare Payment Amount | 65000.18 |
| Total Medical Medicare Standardized Payment Amount | 68223.46 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 212 |
| Number Of Beneficiaries Age 65 to 74 | 583 |
| Number Of Beneficiaries Age 75 to 84 | 575 |
| Number Of Beneficiaries Age Greater 84 | 372 |
| Number Of Female Beneficiaries | 1049 |
| Number Of Male Beneficiaries | 693 |
| Number Of Non Hispanic White Beneficiaries | 1613 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 26 |
| Number Of Hispanic Beneficiaries | 71 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1490 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 252 |
| Percent Of With Atrial Fibrillation | 18 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 14 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.4953 |