| National Provider Identifier [NPI]: | 1609859594 |
| Last Name Of The Provider | BORDLEE |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1800 RYAN ST |
| Street Address 2 Of The Provider | SUITE 105 |
| City Of The Provider | LAKE CHARLES |
| Zip Code Of The Provider | 706016078 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 173 |
| Number Of Services | 9745 |
| Number Of Medicare Beneficiaries | 3639 |
| Total Submitted Charge Amount | 703882 |
| Total Medicare Allowed Amount | 192282.49 |
| Total Medicare Payment Amount | 148087.62 |
| Total Medicare Standardized Payment Amount | 154781.94 |
| 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 | 173 |
| Number Of Medical Services | 9745 |
| Number Of Medicare Beneficiaries With Medical Services | 3639 |
| Total Medical Submitted Charge Amount | 703882 |
| Total Medical Medicare Allowed Amount | 192282.49 |
| Total Medical Medicare Payment Amount | 148087.62 |
| Total Medical Medicare Standardized Payment Amount | 154781.94 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 710 |
| Number Of Beneficiaries Age 65 to 74 | 1389 |
| Number Of Beneficiaries Age 75 to 84 | 1119 |
| Number Of Beneficiaries Age Greater 84 | 421 |
| Number Of Female Beneficiaries | 2290 |
| Number Of Male Beneficiaries | 1349 |
| Number Of Non Hispanic White Beneficiaries | 3211 |
| Number Of Black or African American Beneficiaries | 349 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 52 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2625 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1014 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 29 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 43 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.4722 |