| National Provider Identifier [NPI]: | 1184657496 |
| Last Name Of The Provider | LAVERGNE |
| First Name Of The Provider | BLAINE |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 510 COTTONWOOD ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | BUNKIE |
| Zip Code Of The Provider | 71322 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Emergency Medicine |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 40 |
| Number Of Services | 1538 |
| Number Of Medicare Beneficiaries | 1050 |
| Total Submitted Charge Amount | 1499385 |
| Total Medicare Allowed Amount | 159070.67 |
| Total Medicare Payment Amount | 117481.1 |
| Total Medicare Standardized Payment Amount | 120761.91 |
| 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 | 40 |
| Number Of Medical Services | 1538 |
| Number Of Medicare Beneficiaries With Medical Services | 1050 |
| Total Medical Submitted Charge Amount | 1499385 |
| Total Medical Medicare Allowed Amount | 159070.67 |
| Total Medical Medicare Payment Amount | 117481.1 |
| Total Medical Medicare Standardized Payment Amount | 120761.91 |
| Average Age Of Beneficiaries | 66 |
| Number Of Beneficiaries Age Less65 | 378 |
| Number Of Beneficiaries Age 65 to 74 | 318 |
| Number Of Beneficiaries Age 75 to 84 | 241 |
| Number Of Beneficiaries Age Greater 84 | 113 |
| Number Of Female Beneficiaries | 623 |
| Number Of Male Beneficiaries | 427 |
| Number Of Non Hispanic White Beneficiaries | 636 |
| Number Of Black or African American Beneficiaries | 387 |
| 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 | 429 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 621 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 28 |
| Percent Of With Chronic Kidney Disease | 27 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 37 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 56 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.5304 |