| National Provider Identifier [NPI]: | 1164400107 |
| Last Name Of The Provider | LAUSSADE |
| First Name Of The Provider | MARK |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3061 S MARYLAND PKWY |
| Street Address 2 Of The Provider | SUITE 102 |
| City Of The Provider | LAS VEGAS |
| Zip Code Of The Provider | 891092298 |
| State Code Of The Provider | NV |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 182 |
| Number Of Services | 4915 |
| Number Of Medicare Beneficiaries | 3305 |
| Total Submitted Charge Amount | 536133 |
| Total Medicare Allowed Amount | 170880.69 |
| Total Medicare Payment Amount | 131838.48 |
| Total Medicare Standardized Payment Amount | 131060.15 |
| 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 | 182 |
| Number Of Medical Services | 4915 |
| Number Of Medicare Beneficiaries With Medical Services | 3305 |
| Total Medical Submitted Charge Amount | 536133 |
| Total Medical Medicare Allowed Amount | 170880.69 |
| Total Medical Medicare Payment Amount | 131838.48 |
| Total Medical Medicare Standardized Payment Amount | 131060.15 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 625 |
| Number Of Beneficiaries Age 65 to 74 | 1193 |
| Number Of Beneficiaries Age 75 to 84 | 997 |
| Number Of Beneficiaries Age Greater 84 | 490 |
| Number Of Female Beneficiaries | 1964 |
| Number Of Male Beneficiaries | 1341 |
| Number Of Non Hispanic White Beneficiaries | 2344 |
| Number Of Black or African American Beneficiaries | 431 |
| Number Of AsianPacific Islander Beneficiaries | 160 |
| Number Of Hispanic Beneficiaries | 301 |
| Number Of American Indian Alaska Native Beneficiaries | 14 |
| Number Of Beneficiaries With Race Not Else where Classified | 55 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2471 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 834 |
| Percent Of With Atrial Fibrillation | 20 |
| Percent Of With Alzheimers Disease or Dementia | 20 |
| Percent Of With Asthma | 15 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 33 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 66 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 46 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.1282 |