| National Provider Identifier [NPI]: | 1558364331 |
| Last Name Of The Provider | ELLENDER |
| First Name Of The Provider | LEE |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2967 S UNION ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | OPELOUSAS |
| Zip Code Of The Provider | 705705740 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 3114 |
| Number Of Medicare Beneficiaries | 281 |
| Total Submitted Charge Amount | 225824.93 |
| Total Medicare Allowed Amount | 159420.48 |
| Total Medicare Payment Amount | 116714.47 |
| Total Medicare Standardized Payment Amount | 125369.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 7 |
| Number Of Drug Services | 570 |
| Number Of Medicare Beneficiaries With Drug Services | 131 |
| Total Drug Submitted ChargeAmount | 7805 |
| Total Drug Medicare AllowedAmount | 5346.54 |
| Total Drug Medicare PaymentAmount | 4686.99 |
| Total Drug Medicare Standardized Payment Amount | 4686.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 44 |
| Number Of Medical Services | 2544 |
| Number Of Medicare Beneficiaries With Medical Services | 281 |
| Total Medical Submitted Charge Amount | 218019.93 |
| Total Medical Medicare Allowed Amount | 154073.94 |
| Total Medical Medicare Payment Amount | 112027.48 |
| Total Medical Medicare Standardized Payment Amount | 120682.49 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 28 |
| Number Of Beneficiaries Age 65 to 74 | 125 |
| Number Of Beneficiaries Age 75 to 84 | 88 |
| Number Of Beneficiaries Age Greater 84 | 40 |
| Number Of Female Beneficiaries | 176 |
| Number Of Male Beneficiaries | 105 |
| Number Of Non Hispanic White Beneficiaries | 231 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 198 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 83 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 26 |
| Percent Of With Chronic Kidney Disease | 30 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 43 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.3543 |