National Provider Identifier [NPI]: |
1639259153 |
Last Name Of The Provider |
LOVRETICH |
First Name Of The Provider |
JOHN |
Middle Initial Of The Provider |
O |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
100 WOMANS WAY |
Street Address 2 Of The Provider |
|
City Of The Provider |
BATON ROUGE |
Zip Code Of The Provider |
708175100 |
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 |
65 |
Number Of Services |
1868 |
Number Of Medicare Beneficiaries |
926 |
Total Submitted Charge Amount |
173724 |
Total Medicare Allowed Amount |
44748.08 |
Total Medicare Payment Amount |
36777.44 |
Total Medicare Standardized Payment Amount |
38471.58 |
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 |
65 |
Number Of Medical Services |
1868 |
Number Of Medicare Beneficiaries With Medical Services |
926 |
Total Medical Submitted Charge Amount |
173724 |
Total Medical Medicare Allowed Amount |
44748.08 |
Total Medical Medicare Payment Amount |
36777.44 |
Total Medical Medicare Standardized Payment Amount |
38471.58 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
138 |
Number Of Beneficiaries Age 65 to 74 |
534 |
Number Of Beneficiaries Age 75 to 84 |
221 |
Number Of Beneficiaries Age Greater 84 |
33 |
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
650 |
Number Of Black or African American Beneficiaries |
238 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
736 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
190 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
24 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
11 |
Percent Of With Chronic Obstructive Pulmonary Disease |
5 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
18 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9022 |