National Provider Identifier [NPI]: |
1578514808 |
Last Name Of The Provider |
MERMILLIOD |
First Name Of The Provider |
JULIE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1514 JEFFERSON HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW ORLEANS |
Zip Code Of The Provider |
701212429 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Dermatology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
38 |
Number Of Services |
2229 |
Number Of Medicare Beneficiaries |
515 |
Total Submitted Charge Amount |
172527 |
Total Medicare Allowed Amount |
81185.15 |
Total Medicare Payment Amount |
56534.08 |
Total Medicare Standardized Payment Amount |
57427.75 |
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 |
38 |
Number Of Medical Services |
2229 |
Number Of Medicare Beneficiaries With Medical Services |
515 |
Total Medical Submitted Charge Amount |
172527 |
Total Medical Medicare Allowed Amount |
81185.15 |
Total Medical Medicare Payment Amount |
56534.08 |
Total Medical Medicare Standardized Payment Amount |
57427.75 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
73 |
Number Of Beneficiaries Age 65 to 74 |
245 |
Number Of Beneficiaries Age 75 to 84 |
136 |
Number Of Beneficiaries Age Greater 84 |
61 |
Number Of Female Beneficiaries |
248 |
Number Of Male Beneficiaries |
267 |
Number Of Non Hispanic White Beneficiaries |
419 |
Number Of Black or African American Beneficiaries |
79 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
447 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
68 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
23 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.3026 |