| National Provider Identifier [NPI]: | 1306878509 |
| Last Name Of The Provider | WARREN |
| First Name Of The Provider | TED |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2300 HOSPITAL DR |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | BOSSIER CITY |
| Zip Code Of The Provider | 711112394 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Family Practice |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 94 |
| Number Of Services | 8899 |
| Number Of Medicare Beneficiaries | 1335 |
| Total Submitted Charge Amount | 545842 |
| Total Medicare Allowed Amount | 258873.47 |
| Total Medicare Payment Amount | 195624.79 |
| Total Medicare Standardized Payment Amount | 210504.05 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 2059 |
| Number Of Medicare Beneficiaries With Drug Services | 439 |
| Total Drug Submitted ChargeAmount | 39437 |
| Total Drug Medicare AllowedAmount | 11827.76 |
| Total Drug Medicare PaymentAmount | 10208.83 |
| Total Drug Medicare Standardized Payment Amount | 10208.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 77 |
| Number Of Medical Services | 6840 |
| Number Of Medicare Beneficiaries With Medical Services | 1335 |
| Total Medical Submitted Charge Amount | 506405 |
| Total Medical Medicare Allowed Amount | 247045.71 |
| Total Medical Medicare Payment Amount | 185415.96 |
| Total Medical Medicare Standardized Payment Amount | 200295.22 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 158 |
| Number Of Beneficiaries Age 65 to 74 | 569 |
| Number Of Beneficiaries Age 75 to 84 | 451 |
| Number Of Beneficiaries Age Greater 84 | 157 |
| Number Of Female Beneficiaries | 773 |
| Number Of Male Beneficiaries | 562 |
| Number Of Non Hispanic White Beneficiaries | 1121 |
| Number Of Black or African American Beneficiaries | 180 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 12 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1092 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 243 |
| Percent Of With Atrial Fibrillation | 12 |
| Percent Of With Alzheimers Disease or Dementia | 14 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 22 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 20 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 73 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.3264 |