National Provider Identifier [NPI]: |
1679593651 |
Last Name Of The Provider |
ISABELLE |
First Name Of The Provider |
MICHAEL |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1202 S TYLER ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
COVINGTON |
Zip Code Of The Provider |
704332330 |
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 |
21 |
Number Of Services |
794 |
Number Of Medicare Beneficiaries |
664 |
Total Submitted Charge Amount |
869232 |
Total Medicare Allowed Amount |
107565.55 |
Total Medicare Payment Amount |
81081.74 |
Total Medicare Standardized Payment Amount |
83103.92 |
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 |
21 |
Number Of Medical Services |
794 |
Number Of Medicare Beneficiaries With Medical Services |
664 |
Total Medical Submitted Charge Amount |
869232 |
Total Medical Medicare Allowed Amount |
107565.55 |
Total Medical Medicare Payment Amount |
81081.74 |
Total Medical Medicare Standardized Payment Amount |
83103.92 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
162 |
Number Of Beneficiaries Age 65 to 74 |
179 |
Number Of Beneficiaries Age 75 to 84 |
188 |
Number Of Beneficiaries Age Greater 84 |
135 |
Number Of Female Beneficiaries |
405 |
Number Of Male Beneficiaries |
259 |
Number Of Non Hispanic White Beneficiaries |
509 |
Number Of Black or African American Beneficiaries |
130 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
14 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
373 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
291 |
Percent Of With Atrial Fibrillation |
22 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
13 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
37 |
Percent Of With Chronic Kidney Disease |
45 |
Percent Of With Chronic Obstructive Pulmonary Disease |
33 |
Percent Of With Depression |
38 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
66 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
55 |
Percent Of With Schizophrenia Other PsychoticDisorders |
12 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
2.226 |