National Provider Identifier [NPI]: |
1104010099 |
Last Name Of The Provider |
BROUSSARD |
First Name Of The Provider |
JULIE |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
301 UNIVERSITY BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
GALVESTON |
Zip Code Of The Provider |
775555302 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
99 |
Number Of Services |
897 |
Number Of Medicare Beneficiaries |
710 |
Total Submitted Charge Amount |
1115917 |
Total Medicare Allowed Amount |
102285.24 |
Total Medicare Payment Amount |
78056.99 |
Total Medicare Standardized Payment Amount |
81831.41 |
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 |
99 |
Number Of Medical Services |
897 |
Number Of Medicare Beneficiaries With Medical Services |
710 |
Total Medical Submitted Charge Amount |
1115917 |
Total Medical Medicare Allowed Amount |
102285.24 |
Total Medical Medicare Payment Amount |
78056.99 |
Total Medical Medicare Standardized Payment Amount |
81831.41 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
147 |
Number Of Beneficiaries Age 65 to 74 |
288 |
Number Of Beneficiaries Age 75 to 84 |
205 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
405 |
Number Of Male Beneficiaries |
305 |
Number Of Non Hispanic White Beneficiaries |
518 |
Number Of Black or African American Beneficiaries |
158 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
19 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
484 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
226 |
Percent Of With Atrial Fibrillation |
16 |
Percent Of With Alzheimers Disease or Dementia |
13 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
33 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
53 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
50 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
2.0625 |