National Provider Identifier [NPI]: |
1679510184 |
Last Name Of The Provider |
PAULK |
First Name Of The Provider |
PHILIP |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
801 POINCIANA AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MAMOU |
Zip Code Of The Provider |
705542243 |
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 |
27 |
Number Of Services |
1051 |
Number Of Medicare Beneficiaries |
853 |
Total Submitted Charge Amount |
1209314.2 |
Total Medicare Allowed Amount |
149900.07 |
Total Medicare Payment Amount |
110707.79 |
Total Medicare Standardized Payment Amount |
114193.59 |
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 |
27 |
Number Of Medical Services |
1051 |
Number Of Medicare Beneficiaries With Medical Services |
853 |
Total Medical Submitted Charge Amount |
1209314.2 |
Total Medical Medicare Allowed Amount |
149900.07 |
Total Medical Medicare Payment Amount |
110707.79 |
Total Medical Medicare Standardized Payment Amount |
114193.59 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
255 |
Number Of Beneficiaries Age 65 to 74 |
259 |
Number Of Beneficiaries Age 75 to 84 |
209 |
Number Of Beneficiaries Age Greater 84 |
130 |
Number Of Female Beneficiaries |
458 |
Number Of Male Beneficiaries |
395 |
Number Of Non Hispanic White Beneficiaries |
615 |
Number Of Black or African American Beneficiaries |
210 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
13 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
420 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
433 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
26 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
40 |
Percent Of With Chronic Kidney Disease |
40 |
Percent Of With Chronic Obstructive Pulmonary Disease |
37 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
63 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
13 |
Average HCC Risk Score Of Beneficiaries |
1.9326 |