National Provider Identifier [NPI]: |
1326027632 |
Last Name Of The Provider |
BRUCE |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
8230 SUMMA AVE STE C |
Street Address 2 Of The Provider |
|
City Of The Provider |
BATON ROUGE |
Zip Code Of The Provider |
708093421 |
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 |
162 |
Number Of Services |
2993 |
Number Of Medicare Beneficiaries |
1947 |
Total Submitted Charge Amount |
336439 |
Total Medicare Allowed Amount |
82752.98 |
Total Medicare Payment Amount |
61324.26 |
Total Medicare Standardized Payment Amount |
64965.35 |
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 |
162 |
Number Of Medical Services |
2993 |
Number Of Medicare Beneficiaries With Medical Services |
1947 |
Total Medical Submitted Charge Amount |
336439 |
Total Medical Medicare Allowed Amount |
82752.98 |
Total Medical Medicare Payment Amount |
61324.26 |
Total Medical Medicare Standardized Payment Amount |
64965.35 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
519 |
Number Of Beneficiaries Age 65 to 74 |
709 |
Number Of Beneficiaries Age 75 to 84 |
449 |
Number Of Beneficiaries Age Greater 84 |
270 |
Number Of Female Beneficiaries |
1155 |
Number Of Male Beneficiaries |
792 |
Number Of Non Hispanic White Beneficiaries |
1203 |
Number Of Black or African American Beneficiaries |
688 |
Number Of AsianPacific Islander Beneficiaries |
14 |
Number Of Hispanic Beneficiaries |
29 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1184 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
763 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
18 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
34 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
22 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
38 |
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 |
9 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.9055 |