Carrasco (15-6) allowed three hits, struck out six and retired his final 10 hitters. The right-hander is tied with teammate Corey Kluber, New York's Luis Severino and Boston's Rick Porcello for most wins in the league.
"Any time you send a guy out there and you feel like you've got a good chance to win, that's a good feeling," Indians manager Terry Francona said.
Carrasco's hot streak takes on more significance since fellow starter Trevor Bauer will miss four to six weeks with a stress fracture in his right leg. He was hit by a line drive last week.
Carrasco has been nearly unbeatable since coming off the disabled list last month after being hit on the elbow by a line drive on June 16. He's 7-1 in his last nine appearances, allowing 10 earned runs with 64 strikeouts in 52 innings.
"Nobody wants to go on the DL, but I'm glad I went on the DL to fix some little things," Carrasco said. "That's what it takes sometimes, two or three weeks. At this point I feel fine. I can't wait to start pitching every five days."
Ramirez's first-inning homer tied him with Boston's J.D. Martinez, who entered Friday with the major league lead.
Cleveland has won six straight and is a season-high 19 games over .500 (70-51).
Orioles manager Buck Showalter is impressed with how the Indians are playing.
"That's why they are in first place," he said. "They are one of the best clubs in baseball and they got a great guy in Terry who knows how to use the weapons."
Rookie right-hander David Hess (2-7) allowed two runs in six innings for the Orioles. Trey Mancinci's RBI single in the eighth scored the only run for Baltimore, which has lost 11 of 13.
"That's what you call holding on for dear life," Francona said.
Both starters worked out of bases-loaded jams. Carrasco struck out Rickard to finish the fourth while Hess struck out Yonder Alonso to end the third.
"That is something that gives you confidence not only to throw that pitch, but for that pitch to be called to begin with," Hess said. "That was a big spot."
Orioles outfielder Adam Jones was placed on the bereavement list Friday and is expected to rejoin the team Monday in Toronto.
HALL OF FAMERS
The Indians will honor Hall of Famer Jim Thome on Saturday in a pregame ceremony during which they are expected to retire his No. 25.
The team wouldn't offer confirmation, but a tarp is covering the box in the upper deck in right field between the retired numbers of Indians players who are also in the Hall of Fame -- Bob Lemon (No. 21) and Larry Doby (No. 14).
Thome was inducted into the National Baseball Hall of Fame last month and holds the franchise record with 337 home runs.
Prior to Friday's game, the Indians honored Sheldon Ocker, the 2018 winner of the J.G. Taylor Spink Award. Ocker covered the team for 33 years for the Akron Beacon Journal.
Francona and several Indians players visited outfielder Leonys Martin at the Cleveland Clinic on Thursday. Martin is recovering from a life-threatening bacterial infection and has been hospitalized for over a week.
"He was sitting up in a chair," Francona said. "He looked really good. And he wanted everybody to know he appreciates all the thoughts and everything. It was really uplifting to see him like that."
Orioles: Gentry (left rib fracture) was activated from the 10-day disabled list before the game.
Indians: Francona said it's questionable if DH Edwin Encarnacion (right hand contusion) will come off the 10-day DL on Wednesday, the first day he's eligible. Encarnacion is also dealing with a strained left biceps.
Orioles RHP Alex Cobb (3-15, 5.31) has allowed three earned in 20 innings over his last three starts and will pitch Saturday. RHP Adam Plutko (4-2, 4.75) will be called up from Triple-A Columbus.
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