National Provider Identifier [NPI]: |
1740219138 |
Last Name Of The Provider |
MICKEY |
First Name Of The Provider |
LAUREN |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
102 THOMAS RD |
Street Address 2 Of The Provider |
SUITE 117 |
City Of The Provider |
WEST MONROE |
Zip Code Of The Provider |
712917366 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Otolaryngology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
870 |
Number Of Medicare Beneficiaries |
269 |
Total Submitted Charge Amount |
892893 |
Total Medicare Allowed Amount |
169534.79 |
Total Medicare Payment Amount |
124715.82 |
Total Medicare Standardized Payment Amount |
114853.13 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
20 |
Number Of Medicare Beneficiaries With Drug Services |
13 |
Total Drug Submitted ChargeAmount |
433 |
Total Drug Medicare AllowedAmount |
71.34 |
Total Drug Medicare PaymentAmount |
53.86 |
Total Drug Medicare Standardized Payment Amount |
53.86 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
35 |
Number Of Medical Services |
850 |
Number Of Medicare Beneficiaries With Medical Services |
269 |
Total Medical Submitted Charge Amount |
892460 |
Total Medical Medicare Allowed Amount |
169463.45 |
Total Medical Medicare Payment Amount |
124661.96 |
Total Medical Medicare Standardized Payment Amount |
114799.27 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
24 |
Number Of Beneficiaries Age 65 to 74 |
123 |
Number Of Beneficiaries Age 75 to 84 |
85 |
Number Of Beneficiaries Age Greater 84 |
37 |
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
115 |
Number Of Non Hispanic White Beneficiaries |
252 |
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 |
248 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
21 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
23 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
45 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0336 |