National Provider Identifier [NPI]: |
1588840888 |
Last Name Of The Provider |
VANDERLOOS |
First Name Of The Provider |
CATHERINE |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
MEDICAL DOCTOR |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2508 BERT KOUNS INDUSTRIAL LOOP |
Street Address 2 Of The Provider |
SUITE 400 |
City Of The Provider |
SHREVEPORT |
Zip Code Of The Provider |
711183133 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Obstetrics/Gynecology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
34 |
Number Of Services |
653 |
Number Of Medicare Beneficiaries |
280 |
Total Submitted Charge Amount |
56547 |
Total Medicare Allowed Amount |
44531.52 |
Total Medicare Payment Amount |
30622.49 |
Total Medicare Standardized Payment Amount |
33337.14 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
34 |
Number Of Medical Services |
653 |
Number Of Medicare Beneficiaries With Medical Services |
280 |
Total Medical Submitted Charge Amount |
56547 |
Total Medical Medicare Allowed Amount |
44531.52 |
Total Medical Medicare Payment Amount |
30622.49 |
Total Medical Medicare Standardized Payment Amount |
33337.14 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
19 |
Number Of Beneficiaries Age 65 to 74 |
167 |
Number Of Beneficiaries Age 75 to 84 |
78 |
Number Of Beneficiaries Age Greater 84 |
16 |
Number Of Female Beneficiaries |
280 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
242 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
269 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
11 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
5 |
Percent Of With Cancer |
5 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
10 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
18 |
Percent Of With Diabetes |
17 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
21 |
Percent Of With Osteoporosis |
16 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
0.7613 |