National Provider Identifier [NPI]: |
1033131800 |
Last Name Of The Provider |
FONTENOT |
First Name Of The Provider |
CATHI |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3700 SAINT CHARLES AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW ORLEANS |
Zip Code Of The Provider |
701154637 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
291 |
Number Of Medicare Beneficiaries |
86 |
Total Submitted Charge Amount |
38009 |
Total Medicare Allowed Amount |
17833.81 |
Total Medicare Payment Amount |
12290.61 |
Total Medicare Standardized Payment Amount |
12448.64 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
42 |
Number Of Medicare Beneficiaries With Drug Services |
31 |
Total Drug Submitted ChargeAmount |
2379 |
Total Drug Medicare AllowedAmount |
1174.84 |
Total Drug Medicare PaymentAmount |
1136.38 |
Total Drug Medicare Standardized Payment Amount |
1136.38 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
10 |
Number Of Medical Services |
249 |
Number Of Medicare Beneficiaries With Medical Services |
85 |
Total Medical Submitted Charge Amount |
35630 |
Total Medical Medicare Allowed Amount |
16658.97 |
Total Medical Medicare Payment Amount |
11154.23 |
Total Medical Medicare Standardized Payment Amount |
11312.26 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
51 |
Number Of Beneficiaries Age 75 to 84 |
24 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
64 |
Number Of Male Beneficiaries |
22 |
Number Of Non Hispanic White Beneficiaries |
58 |
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 |
|
Number Of Beneficiaries With Medicare Medicaid Entitlement |
|
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
|
Percent Of With Chronic Kidney Disease |
|
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
|
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
14 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.6959 |