National Provider Identifier [NPI]: |
1992767404 |
Last Name Of The Provider |
LONG |
First Name Of The Provider |
WILLIAM |
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 |
3704 NORTH BLVD |
Street Address 2 Of The Provider |
SUITE 1 |
City Of The Provider |
ALEXANDRIA |
Zip Code Of The Provider |
713013606 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
230 |
Number Of Services |
6874 |
Number Of Medicare Beneficiaries |
2459 |
Total Submitted Charge Amount |
2438769 |
Total Medicare Allowed Amount |
614780.47 |
Total Medicare Payment Amount |
476144.37 |
Total Medicare Standardized Payment Amount |
519517.07 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
10 |
Number Of Drug Services |
2514 |
Number Of Medicare Beneficiaries With Drug Services |
206 |
Total Drug Submitted ChargeAmount |
101190 |
Total Drug Medicare AllowedAmount |
2113.12 |
Total Drug Medicare PaymentAmount |
1614.82 |
Total Drug Medicare Standardized Payment Amount |
1614.82 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
220 |
Number Of Medical Services |
4360 |
Number Of Medicare Beneficiaries With Medical Services |
2459 |
Total Medical Submitted Charge Amount |
2337579 |
Total Medical Medicare Allowed Amount |
612667.35 |
Total Medical Medicare Payment Amount |
474529.55 |
Total Medical Medicare Standardized Payment Amount |
517902.25 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
549 |
Number Of Beneficiaries Age 65 to 74 |
863 |
Number Of Beneficiaries Age 75 to 84 |
748 |
Number Of Beneficiaries Age Greater 84 |
299 |
Number Of Female Beneficiaries |
1342 |
Number Of Male Beneficiaries |
1117 |
Number Of Non Hispanic White Beneficiaries |
1804 |
Number Of Black or African American Beneficiaries |
601 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
17 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
17 |
Number Of Beneficiaries With Medicare Only Entitlement |
1503 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
956 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
48 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
65 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.0523 |