National Provider Identifier [NPI]: |
1669589164 |
Last Name Of The Provider |
GILLESPIE |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1103 KALISTE SALOOM RD |
Street Address 2 Of The Provider |
SUITE 202 |
City Of The Provider |
LAFAYETTE |
Zip Code Of The Provider |
705085783 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Interventional Pain Management |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
54 |
Number Of Services |
3295 |
Number Of Medicare Beneficiaries |
408 |
Total Submitted Charge Amount |
433964.7 |
Total Medicare Allowed Amount |
178358.74 |
Total Medicare Payment Amount |
125221.05 |
Total Medicare Standardized Payment Amount |
139087.05 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
5 |
Number Of Drug Services |
906 |
Number Of Medicare Beneficiaries With Drug Services |
250 |
Total Drug Submitted ChargeAmount |
14406 |
Total Drug Medicare AllowedAmount |
3217.58 |
Total Drug Medicare PaymentAmount |
2251.27 |
Total Drug Medicare Standardized Payment Amount |
2251.27 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
49 |
Number Of Medical Services |
2389 |
Number Of Medicare Beneficiaries With Medical Services |
408 |
Total Medical Submitted Charge Amount |
419558.7 |
Total Medical Medicare Allowed Amount |
175141.16 |
Total Medical Medicare Payment Amount |
122969.78 |
Total Medical Medicare Standardized Payment Amount |
136835.78 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
182 |
Number Of Beneficiaries Age 65 to 74 |
119 |
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
226 |
Number Of Male Beneficiaries |
182 |
Number Of Non Hispanic White Beneficiaries |
336 |
Number Of Black or African American Beneficiaries |
53 |
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 |
306 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
102 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
19 |
Percent Of With Depression |
41 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
58 |
Percent Of With Hypertension |
72 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
75 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.6606 |