National Provider Identifier [NPI]: |
1386649788 |
Last Name Of The Provider |
BABER |
First Name Of The Provider |
WILSON |
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 |
734 N ASHLEY RIDGE LOOP |
Street Address 2 Of The Provider |
|
City Of The Provider |
SHREVEPORT |
Zip Code Of The Provider |
711067209 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
31 |
Number Of Services |
11047 |
Number Of Medicare Beneficiaries |
1449 |
Total Submitted Charge Amount |
5622079 |
Total Medicare Allowed Amount |
1846855.81 |
Total Medicare Payment Amount |
1405455.28 |
Total Medicare Standardized Payment Amount |
1445946.92 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
3098 |
Number Of Medicare Beneficiaries With Drug Services |
225 |
Total Drug Submitted ChargeAmount |
3374932 |
Total Drug Medicare AllowedAmount |
1176010.84 |
Total Drug Medicare PaymentAmount |
911252.85 |
Total Drug Medicare Standardized Payment Amount |
911252.85 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
26 |
Number Of Medical Services |
7949 |
Number Of Medicare Beneficiaries With Medical Services |
1449 |
Total Medical Submitted Charge Amount |
2247147 |
Total Medical Medicare Allowed Amount |
670844.97 |
Total Medical Medicare Payment Amount |
494202.43 |
Total Medical Medicare Standardized Payment Amount |
534694.07 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
106 |
Number Of Beneficiaries Age 65 to 74 |
558 |
Number Of Beneficiaries Age 75 to 84 |
509 |
Number Of Beneficiaries Age Greater 84 |
276 |
Number Of Female Beneficiaries |
882 |
Number Of Male Beneficiaries |
567 |
Number Of Non Hispanic White Beneficiaries |
1199 |
Number Of Black or African American Beneficiaries |
211 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
20 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1252 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
197 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
14 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
40 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.385 |