National Provider Identifier [NPI]: |
1407803547 |
Last Name Of The Provider |
GODEAUX |
First Name Of The Provider |
GUY |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
539 E PRUDHOMME ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
OPELOUSAS |
Zip Code Of The Provider |
705706499 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Emergency Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
970 |
Number Of Medicare Beneficiaries |
451 |
Total Submitted Charge Amount |
567195 |
Total Medicare Allowed Amount |
74277.27 |
Total Medicare Payment Amount |
53756.92 |
Total Medicare Standardized Payment Amount |
56020.98 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
6 |
Number Of Drug Services |
154 |
Number Of Medicare Beneficiaries With Drug Services |
76 |
Total Drug Submitted ChargeAmount |
1689 |
Total Drug Medicare AllowedAmount |
881.66 |
Total Drug Medicare PaymentAmount |
574.17 |
Total Drug Medicare Standardized Payment Amount |
574.17 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
48 |
Number Of Medical Services |
816 |
Number Of Medicare Beneficiaries With Medical Services |
451 |
Total Medical Submitted Charge Amount |
565506 |
Total Medical Medicare Allowed Amount |
73395.61 |
Total Medical Medicare Payment Amount |
53182.75 |
Total Medical Medicare Standardized Payment Amount |
55446.81 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
121 |
Number Of Beneficiaries Age 65 to 74 |
154 |
Number Of Beneficiaries Age 75 to 84 |
125 |
Number Of Beneficiaries Age Greater 84 |
51 |
Number Of Female Beneficiaries |
251 |
Number Of Male Beneficiaries |
200 |
Number Of Non Hispanic White Beneficiaries |
287 |
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 |
244 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
207 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
19 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
32 |
Percent Of With Chronic Kidney Disease |
29 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
33 |
Percent Of With Diabetes |
37 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.6337 |