| National Provider Identifier [NPI]: | 1689884199 |
| Last Name Of The Provider | LABORDE |
| First Name Of The Provider | JEREMY |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1501 KINGS HWY |
| Street Address 2 Of The Provider | DEPARTMENT OF RADIOLOGY |
| City Of The Provider | SHREVEPORT |
| Zip Code Of The Provider | 711034228 |
| 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 | 184 |
| Number Of Services | 4101 |
| Number Of Medicare Beneficiaries | 2842 |
| Total Submitted Charge Amount | 754551 |
| Total Medicare Allowed Amount | 191361.55 |
| Total Medicare Payment Amount | 146497.6 |
| Total Medicare Standardized Payment Amount | 154501.89 |
| 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 | 184 |
| Number Of Medical Services | 4101 |
| Number Of Medicare Beneficiaries With Medical Services | 2842 |
| Total Medical Submitted Charge Amount | 754551 |
| Total Medical Medicare Allowed Amount | 191361.55 |
| Total Medical Medicare Payment Amount | 146497.6 |
| Total Medical Medicare Standardized Payment Amount | 154501.89 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 665 |
| Number Of Beneficiaries Age 65 to 74 | 1230 |
| Number Of Beneficiaries Age 75 to 84 | 726 |
| Number Of Beneficiaries Age Greater 84 | 221 |
| Number Of Female Beneficiaries | 1611 |
| Number Of Male Beneficiaries | 1231 |
| Number Of Non Hispanic White Beneficiaries | 2064 |
| Number Of Black or African American Beneficiaries | 665 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 60 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 29 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1948 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 894 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 23 |
| Percent Of With Chronic Kidney Disease | 25 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 6 |
| Average HCC Risk Score Of Beneficiaries | 1.3598 |