| National Provider Identifier [NPI]: | 1235131269 |
| Last Name Of The Provider | HATHORN |
| First Name Of The Provider | BRYAN |
| Middle Initial Of The Provider | S |
| 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 1000 |
| 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 | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 76 |
| Number Of Services | 4444 |
| Number Of Medicare Beneficiaries | 844 |
| Total Submitted Charge Amount | 538504 |
| Total Medicare Allowed Amount | 238387.19 |
| Total Medicare Payment Amount | 173445.75 |
| Total Medicare Standardized Payment Amount | 187348.23 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 1793 |
| Number Of Medicare Beneficiaries With Drug Services | 18 |
| Total Drug Submitted ChargeAmount | 2075 |
| Total Drug Medicare AllowedAmount | 427.81 |
| Total Drug Medicare PaymentAmount | 312.11 |
| Total Drug Medicare Standardized Payment Amount | 312.11 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 74 |
| Number Of Medical Services | 2651 |
| Number Of Medicare Beneficiaries With Medical Services | 844 |
| Total Medical Submitted Charge Amount | 536429 |
| Total Medical Medicare Allowed Amount | 237959.38 |
| Total Medical Medicare Payment Amount | 173133.64 |
| Total Medical Medicare Standardized Payment Amount | 187036.12 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 87 |
| Number Of Beneficiaries Age 65 to 74 | 360 |
| Number Of Beneficiaries Age 75 to 84 | 263 |
| Number Of Beneficiaries Age Greater 84 | 134 |
| Number Of Female Beneficiaries | 411 |
| Number Of Male Beneficiaries | 433 |
| Number Of Non Hispanic White Beneficiaries | 674 |
| Number Of Black or African American Beneficiaries | 146 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 698 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 146 |
| Percent Of With Atrial Fibrillation | 25 |
| Percent Of With Alzheimers Disease or Dementia | 13 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 17 |
| Percent Of With Depression | 22 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 73 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 60 |
| Percent Of With Osteoporosis | 6 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 39 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 1.5661 |