National Provider Identifier [NPI]: |
1174590848 |
Last Name Of The Provider |
MILLER |
First Name Of The Provider |
CRAIG |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1449 E BERT KOUNS LOOP |
Street Address 2 Of The Provider |
SUITE 100 |
City Of The Provider |
SHREVEPORT |
Zip Code Of The Provider |
711055663 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
60 |
Number Of Services |
4875 |
Number Of Medicare Beneficiaries |
720 |
Total Submitted Charge Amount |
346515.5 |
Total Medicare Allowed Amount |
279348.06 |
Total Medicare Payment Amount |
209855.58 |
Total Medicare Standardized Payment Amount |
204788.62 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
1056 |
Number Of Medicare Beneficiaries With Drug Services |
212 |
Total Drug Submitted ChargeAmount |
8592.5 |
Total Drug Medicare AllowedAmount |
3858.26 |
Total Drug Medicare PaymentAmount |
3735.81 |
Total Drug Medicare Standardized Payment Amount |
3735.81 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
3819 |
Number Of Medicare Beneficiaries With Medical Services |
720 |
Total Medical Submitted Charge Amount |
337923 |
Total Medical Medicare Allowed Amount |
275489.8 |
Total Medical Medicare Payment Amount |
206119.77 |
Total Medical Medicare Standardized Payment Amount |
201052.81 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
32 |
Number Of Beneficiaries Age 65 to 74 |
302 |
Number Of Beneficiaries Age 75 to 84 |
281 |
Number Of Beneficiaries Age Greater 84 |
105 |
Number Of Female Beneficiaries |
405 |
Number Of Male Beneficiaries |
315 |
Number Of Non Hispanic White Beneficiaries |
660 |
Number Of Black or African American Beneficiaries |
47 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
662 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
58 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
43 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
49 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.3444 |