| National Provider Identifier [NPI]: | 1417941162 |
| Last Name Of The Provider | GALLIEN |
| First Name Of The Provider | JEROME |
| Middle Initial Of The Provider | |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1634 ELTON RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | JENNINGS |
| Zip Code Of The Provider | 705463614 |
| 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 | 170 |
| Number Of Services | 5642 |
| Number Of Medicare Beneficiaries | 2474 |
| Total Submitted Charge Amount | 440441.72 |
| Total Medicare Allowed Amount | 145053.48 |
| Total Medicare Payment Amount | 107275.42 |
| Total Medicare Standardized Payment Amount | 112499.85 |
| 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 | 170 |
| Number Of Medical Services | 5642 |
| Number Of Medicare Beneficiaries With Medical Services | 2474 |
| Total Medical Submitted Charge Amount | 440441.72 |
| Total Medical Medicare Allowed Amount | 145053.48 |
| Total Medical Medicare Payment Amount | 107275.42 |
| Total Medical Medicare Standardized Payment Amount | 112499.85 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 496 |
| Number Of Beneficiaries Age 65 to 74 | 898 |
| Number Of Beneficiaries Age 75 to 84 | 715 |
| Number Of Beneficiaries Age Greater 84 | 365 |
| Number Of Female Beneficiaries | 1479 |
| Number Of Male Beneficiaries | 995 |
| Number Of Non Hispanic White Beneficiaries | 2065 |
| Number Of Black or African American Beneficiaries | 347 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 36 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 13 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1603 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 871 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 31 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 36 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 46 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 44 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.3981 |