| National Provider Identifier [NPI]: | 1871591123 |
| Last Name Of The Provider | MANUEL |
| First Name Of The Provider | NICHOLAS |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3704 NORTH BLVD |
| Street Address 2 Of The Provider | STE 1 |
| City Of The Provider | ALEXANDRIA |
| Zip Code Of The Provider | 713013606 |
| 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 | 183 |
| Number Of Services | 12733 |
| Number Of Medicare Beneficiaries | 7268 |
| Total Submitted Charge Amount | 1218691 |
| Total Medicare Allowed Amount | 318956.58 |
| Total Medicare Payment Amount | 237789.71 |
| Total Medicare Standardized Payment Amount | 249098.57 |
| 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 | 183 |
| Number Of Medical Services | 12733 |
| Number Of Medicare Beneficiaries With Medical Services | 7268 |
| Total Medical Submitted Charge Amount | 1218691 |
| Total Medical Medicare Allowed Amount | 318956.58 |
| Total Medical Medicare Payment Amount | 237789.71 |
| Total Medical Medicare Standardized Payment Amount | 249098.57 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 1650 |
| Number Of Beneficiaries Age 65 to 74 | 2809 |
| Number Of Beneficiaries Age 75 to 84 | 1993 |
| Number Of Beneficiaries Age Greater 84 | 816 |
| Number Of Female Beneficiaries | 4425 |
| Number Of Male Beneficiaries | 2843 |
| Number Of Non Hispanic White Beneficiaries | 5482 |
| Number Of Black or African American Beneficiaries | 1632 |
| Number Of AsianPacific Islander Beneficiaries | 30 |
| Number Of Hispanic Beneficiaries | 58 |
| Number Of American Indian Alaska Native Beneficiaries | 24 |
| Number Of Beneficiaries With Race Not Else where Classified | 42 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4438 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2830 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 59 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.6437 |