| National Provider Identifier [NPI]: | 1588600894 |
| Last Name Of The Provider | ITELD |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD,FACC,FCCP,FSCAI |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 901 GAUSE BLVD |
| Street Address 2 Of The Provider | 2ND FLOOR |
| City Of The Provider | SLIDELL |
| Zip Code Of The Provider | 704582937 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 137 |
| Number Of Services | 9993 |
| Number Of Medicare Beneficiaries | 1539 |
| Total Submitted Charge Amount | 1913387 |
| Total Medicare Allowed Amount | 774906.72 |
| Total Medicare Payment Amount | 576040.48 |
| Total Medicare Standardized Payment Amount | 623691.64 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 10 |
| Number Of Drug Services | 1021 |
| Number Of Medicare Beneficiaries With Drug Services | 270 |
| Total Drug Submitted ChargeAmount | 68335 |
| Total Drug Medicare AllowedAmount | 33560.88 |
| Total Drug Medicare PaymentAmount | 25574.18 |
| Total Drug Medicare Standardized Payment Amount | 25574.18 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 127 |
| Number Of Medical Services | 8972 |
| Number Of Medicare Beneficiaries With Medical Services | 1538 |
| Total Medical Submitted Charge Amount | 1845052 |
| Total Medical Medicare Allowed Amount | 741345.84 |
| Total Medical Medicare Payment Amount | 550466.3 |
| Total Medical Medicare Standardized Payment Amount | 598117.46 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 284 |
| Number Of Beneficiaries Age 65 to 74 | 537 |
| Number Of Beneficiaries Age 75 to 84 | 453 |
| Number Of Beneficiaries Age Greater 84 | 265 |
| Number Of Female Beneficiaries | 827 |
| Number Of Male Beneficiaries | 712 |
| Number Of Non Hispanic White Beneficiaries | 1207 |
| Number Of Black or African American Beneficiaries | 258 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1030 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 509 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 29 |
| Percent Of With Diabetes | 48 |
| Percent Of With Hyperlipidemia | 71 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 68 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 48 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 2.0904 |