National Provider Identifier [NPI]: |
1043447196 |
Last Name Of The Provider |
ELIAS |
First Name Of The Provider |
ERIC |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1546 GARY DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
BREAUX BRIDGE |
Zip Code Of The Provider |
705173447 |
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 |
37 |
Number Of Services |
490 |
Number Of Medicare Beneficiaries |
149 |
Total Submitted Charge Amount |
85444.5 |
Total Medicare Allowed Amount |
38817.53 |
Total Medicare Payment Amount |
32034.19 |
Total Medicare Standardized Payment Amount |
34060.11 |
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 |
37 |
Number Of Medical Services |
490 |
Number Of Medicare Beneficiaries With Medical Services |
149 |
Total Medical Submitted Charge Amount |
85444.5 |
Total Medical Medicare Allowed Amount |
38817.53 |
Total Medical Medicare Payment Amount |
32034.19 |
Total Medical Medicare Standardized Payment Amount |
34060.11 |
Average Age Of Beneficiaries |
64 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
54 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
149 |
Number Of Male Beneficiaries |
0 |
Number Of Non Hispanic White Beneficiaries |
111 |
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 |
86 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
63 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
9 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0092 |