| National Provider Identifier [NPI]: | 1518960962 |
| Last Name Of The Provider | ECHENIQUE |
| First Name Of The Provider | VICTOR |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1051 GAUSE BLVD |
| Street Address 2 Of The Provider | STE 320 |
| City Of The Provider | SLIDELL |
| Zip Code Of The Provider | 704582988 |
| 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 | 70 |
| Number Of Services | 4822 |
| Number Of Medicare Beneficiaries | 1176 |
| Total Submitted Charge Amount | 1004881 |
| Total Medicare Allowed Amount | 330243.88 |
| Total Medicare Payment Amount | 241358.98 |
| Total Medicare Standardized Payment Amount | 260607.99 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 5 |
| Number Of Drug Services | 401 |
| Number Of Medicare Beneficiaries With Drug Services | 111 |
| Total Drug Submitted ChargeAmount | 44035 |
| Total Drug Medicare AllowedAmount | 18537.91 |
| Total Drug Medicare PaymentAmount | 14115.49 |
| Total Drug Medicare Standardized Payment Amount | 14115.49 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 65 |
| Number Of Medical Services | 4421 |
| Number Of Medicare Beneficiaries With Medical Services | 1175 |
| Total Medical Submitted Charge Amount | 960846 |
| Total Medical Medicare Allowed Amount | 311705.97 |
| Total Medical Medicare Payment Amount | 227243.49 |
| Total Medical Medicare Standardized Payment Amount | 246492.5 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 149 |
| Number Of Beneficiaries Age 65 to 74 | 449 |
| Number Of Beneficiaries Age 75 to 84 | 375 |
| Number Of Beneficiaries Age Greater 84 | 203 |
| Number Of Female Beneficiaries | 625 |
| Number Of Male Beneficiaries | 551 |
| Number Of Non Hispanic White Beneficiaries | 1006 |
| Number Of Black or African American Beneficiaries | 118 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 40 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 968 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 208 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 17 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 13 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 40 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 25 |
| Percent Of With Diabetes | 45 |
| Percent Of With Hyperlipidemia | 75 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 72 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.8298 |