| National Provider Identifier [NPI]: | 1689634099 |
| Last Name Of The Provider | VICK |
| First Name Of The Provider | STEPHEN |
| 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 | 7777 HENNESSY BLVD |
| Street Address 2 Of The Provider | SUITE 2004 |
| City Of The Provider | BATON ROUGE |
| Zip Code Of The Provider | 708084300 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 134 |
| Number Of Services | 16647 |
| Number Of Medicare Beneficiaries | 791 |
| Total Submitted Charge Amount | 1106547.5 |
| Total Medicare Allowed Amount | 390956.38 |
| Total Medicare Payment Amount | 296645.66 |
| Total Medicare Standardized Payment Amount | 322086.75 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 10809 |
| Number Of Medicare Beneficiaries With Drug Services | 118 |
| Total Drug Submitted ChargeAmount | 158492.5 |
| Total Drug Medicare AllowedAmount | 49791.92 |
| Total Drug Medicare PaymentAmount | 38763.13 |
| Total Drug Medicare Standardized Payment Amount | 38763.13 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 126 |
| Number Of Medical Services | 5838 |
| Number Of Medicare Beneficiaries With Medical Services | 791 |
| Total Medical Submitted Charge Amount | 948055 |
| Total Medical Medicare Allowed Amount | 341164.46 |
| Total Medical Medicare Payment Amount | 257882.53 |
| Total Medical Medicare Standardized Payment Amount | 283323.62 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 100 |
| Number Of Beneficiaries Age 65 to 74 | 375 |
| Number Of Beneficiaries Age 75 to 84 | 226 |
| Number Of Beneficiaries Age Greater 84 | 90 |
| Number Of Female Beneficiaries | 216 |
| Number Of Male Beneficiaries | 575 |
| Number Of Non Hispanic White Beneficiaries | 594 |
| Number Of Black or African American Beneficiaries | 152 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 23 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 670 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 121 |
| Percent Of With Atrial Fibrillation | 14 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 21 |
| Percent Of With Heart Failure | 18 |
| Percent Of With Chronic Kidney Disease | 32 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 61 |
| Percent Of With Hypertension | 71 |
| Percent Of With Ischemic Heart Disease | 36 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.2896 |