National Provider Identifier [NPI]: |
1750373338 |
Last Name Of The Provider |
ADAMS |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
N |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1500 LINE AVENUE |
Street Address 2 Of The Provider |
STE 200 |
City Of The Provider |
SHREVEPORT |
Zip Code Of The Provider |
71101 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Physical Medicine and Rehabilitation |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
4632 |
Number Of Medicare Beneficiaries |
1041 |
Total Submitted Charge Amount |
1582946 |
Total Medicare Allowed Amount |
428885.38 |
Total Medicare Payment Amount |
327037.76 |
Total Medicare Standardized Payment Amount |
309908.86 |
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 |
18 |
Number Of Medical Services |
4632 |
Number Of Medicare Beneficiaries With Medical Services |
1041 |
Total Medical Submitted Charge Amount |
1582946 |
Total Medical Medicare Allowed Amount |
428885.38 |
Total Medical Medicare Payment Amount |
327037.76 |
Total Medical Medicare Standardized Payment Amount |
309908.86 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
200 |
Number Of Beneficiaries Age 65 to 74 |
493 |
Number Of Beneficiaries Age 75 to 84 |
282 |
Number Of Beneficiaries Age Greater 84 |
66 |
Number Of Female Beneficiaries |
641 |
Number Of Male Beneficiaries |
400 |
Number Of Non Hispanic White Beneficiaries |
858 |
Number Of Black or African American Beneficiaries |
168 |
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 |
904 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
137 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
9 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
59 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0871 |