National Provider Identifier [NPI]: |
1215910112 |
Last Name Of The Provider |
BRDLIK |
First Name Of The Provider |
CHARLES |
Middle Initial Of The Provider |
J |
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 |
229 |
Number Of Services |
21494.5 |
Number Of Medicare Beneficiaries |
5780 |
Total Submitted Charge Amount |
2040920.13 |
Total Medicare Allowed Amount |
404253.09 |
Total Medicare Payment Amount |
305065.92 |
Total Medicare Standardized Payment Amount |
326913.36 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
3 |
Number Of Drug Services |
11281.5 |
Number Of Medicare Beneficiaries With Drug Services |
163 |
Total Drug Submitted ChargeAmount |
46608.13 |
Total Drug Medicare AllowedAmount |
6387.51 |
Total Drug Medicare PaymentAmount |
4950.36 |
Total Drug Medicare Standardized Payment Amount |
4950.36 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
226 |
Number Of Medical Services |
10213 |
Number Of Medicare Beneficiaries With Medical Services |
5779 |
Total Medical Submitted Charge Amount |
1994312 |
Total Medical Medicare Allowed Amount |
397865.58 |
Total Medical Medicare Payment Amount |
300115.56 |
Total Medical Medicare Standardized Payment Amount |
321963 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
1180 |
Number Of Beneficiaries Age 65 to 74 |
2246 |
Number Of Beneficiaries Age 75 to 84 |
1683 |
Number Of Beneficiaries Age Greater 84 |
671 |
Number Of Female Beneficiaries |
3542 |
Number Of Male Beneficiaries |
2238 |
Number Of Non Hispanic White Beneficiaries |
4440 |
Number Of Black or African American Beneficiaries |
1218 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
58 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
37 |
Number Of Beneficiaries With Medicare Only Entitlement |
4180 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
1600 |
Percent Of With Atrial Fibrillation |
15 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
12 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
31 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
46 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
11 |
Average HCC Risk Score Of Beneficiaries |
1.5991 |