National Provider Identifier [NPI]: |
1396735759 |
Last Name Of The Provider |
STAFFORD |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1453 E BERT KOUNS INDUSTRIAL LOOP |
Street Address 2 Of The Provider |
SUITE 315 |
City Of The Provider |
SHREVEPORT |
Zip Code Of The Provider |
711056800 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
75 |
Number Of Services |
5274 |
Number Of Medicare Beneficiaries |
1135 |
Total Submitted Charge Amount |
943877 |
Total Medicare Allowed Amount |
372642.09 |
Total Medicare Payment Amount |
270642.09 |
Total Medicare Standardized Payment Amount |
296938.41 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
1 |
Number Of Drug Services |
160 |
Number Of Medicare Beneficiaries With Drug Services |
40 |
Total Drug Submitted ChargeAmount |
10272 |
Total Drug Medicare AllowedAmount |
8445.15 |
Total Drug Medicare PaymentAmount |
6335.24 |
Total Drug Medicare Standardized Payment Amount |
6335.24 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
74 |
Number Of Medical Services |
5114 |
Number Of Medicare Beneficiaries With Medical Services |
1135 |
Total Medical Submitted Charge Amount |
933605 |
Total Medical Medicare Allowed Amount |
364196.94 |
Total Medical Medicare Payment Amount |
264306.85 |
Total Medical Medicare Standardized Payment Amount |
290603.17 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
83 |
Number Of Beneficiaries Age 65 to 74 |
442 |
Number Of Beneficiaries Age 75 to 84 |
424 |
Number Of Beneficiaries Age Greater 84 |
186 |
Number Of Female Beneficiaries |
576 |
Number Of Male Beneficiaries |
559 |
Number Of Non Hispanic White Beneficiaries |
917 |
Number Of Black or African American Beneficiaries |
194 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
992 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
143 |
Percent Of With Atrial Fibrillation |
38 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
34 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
75 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
67 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.5166 |