| National Provider Identifier [NPI]: | 1811189087 |
| Last Name Of The Provider | CLAVILLE |
| First Name Of The Provider | JONI |
| Middle Initial Of The Provider | N |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 5825 AIRLINE HWY |
| Street Address 2 Of The Provider | EMERGENCY MEDICINE RESIDENCY PROGRAM |
| City Of The Provider | BATON ROUGE |
| Zip Code Of The Provider | 708052408 |
| 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 | 29 |
| Number Of Services | 1016 |
| Number Of Medicare Beneficiaries | 742 |
| Total Submitted Charge Amount | 1124851 |
| Total Medicare Allowed Amount | 144970.31 |
| Total Medicare Payment Amount | 107927.69 |
| Total Medicare Standardized Payment Amount | 111089.04 |
| 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 | 29 |
| Number Of Medical Services | 1016 |
| Number Of Medicare Beneficiaries With Medical Services | 742 |
| Total Medical Submitted Charge Amount | 1124851 |
| Total Medical Medicare Allowed Amount | 144970.31 |
| Total Medical Medicare Payment Amount | 107927.69 |
| Total Medical Medicare Standardized Payment Amount | 111089.04 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 234 |
| Number Of Beneficiaries Age 65 to 74 | 200 |
| Number Of Beneficiaries Age 75 to 84 | 191 |
| Number Of Beneficiaries Age Greater 84 | 117 |
| Number Of Female Beneficiaries | 399 |
| Number Of Male Beneficiaries | 343 |
| Number Of Non Hispanic White Beneficiaries | 535 |
| Number Of Black or African American Beneficiaries | 185 |
| 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 | 352 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 390 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 22 |
| Percent Of With Asthma | 19 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 43 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 37 |
| Percent Of With Depression | 38 |
| Percent Of With Diabetes | 44 |
| Percent Of With Hyperlipidemia | 64 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 64 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 13 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.9471 |