National Provider Identifier [NPI]: |
1053350009 |
Last Name Of The Provider |
SMITH |
First Name Of The Provider |
RICHARD |
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 |
3510 MAGNOLIA COVE |
Street Address 2 Of The Provider |
STE 120 |
City Of The Provider |
MONROE |
Zip Code Of The Provider |
71203 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
3457 |
Number Of Medicare Beneficiaries |
962 |
Total Submitted Charge Amount |
316005.4 |
Total Medicare Allowed Amount |
152655.21 |
Total Medicare Payment Amount |
113895.41 |
Total Medicare Standardized Payment Amount |
121550.13 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
353 |
Number Of Medicare Beneficiaries With Drug Services |
120 |
Total Drug Submitted ChargeAmount |
6294.54 |
Total Drug Medicare AllowedAmount |
3124.67 |
Total Drug Medicare PaymentAmount |
2947.1 |
Total Drug Medicare Standardized Payment Amount |
2947.1 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
43 |
Number Of Medical Services |
3104 |
Number Of Medicare Beneficiaries With Medical Services |
962 |
Total Medical Submitted Charge Amount |
309710.86 |
Total Medical Medicare Allowed Amount |
149530.54 |
Total Medical Medicare Payment Amount |
110948.31 |
Total Medical Medicare Standardized Payment Amount |
118603.03 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
194 |
Number Of Beneficiaries Age 65 to 74 |
349 |
Number Of Beneficiaries Age 75 to 84 |
283 |
Number Of Beneficiaries Age Greater 84 |
136 |
Number Of Female Beneficiaries |
546 |
Number Of Male Beneficiaries |
416 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
479 |
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 |
591 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
371 |
Percent Of With Atrial Fibrillation |
17 |
Percent Of With Alzheimers Disease or Dementia |
22 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
38 |
Percent Of With Chronic Kidney Disease |
41 |
Percent Of With Chronic Obstructive Pulmonary Disease |
27 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
43 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
50 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.9363 |