| National Provider Identifier [NPI]: | 1992864128 |
| Last Name Of The Provider | SEDRISH |
| First Name Of The Provider | PHILLIP |
| Middle Initial Of The Provider | P |
| Credentials Of The Provider | MD, FACR |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1051 GAUSE BLVD |
| Street Address 2 Of The Provider | # 440 |
| City Of The Provider | SLIDELL |
| Zip Code Of The Provider | 704582951 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 23 |
| Number Of Services | 1282 |
| Number Of Medicare Beneficiaries | 292 |
| Total Submitted Charge Amount | 147502 |
| Total Medicare Allowed Amount | 77748.45 |
| Total Medicare Payment Amount | 51547.78 |
| Total Medicare Standardized Payment Amount | 57998.18 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 376 |
| Number Of Medicare Beneficiaries With Drug Services | 47 |
| Total Drug Submitted ChargeAmount | 1800 |
| Total Drug Medicare AllowedAmount | 869.8 |
| Total Drug Medicare PaymentAmount | 589.83 |
| Total Drug Medicare Standardized Payment Amount | 589.83 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 20 |
| Number Of Medical Services | 906 |
| Number Of Medicare Beneficiaries With Medical Services | 292 |
| Total Medical Submitted Charge Amount | 145702 |
| Total Medical Medicare Allowed Amount | 76878.65 |
| Total Medical Medicare Payment Amount | 50957.95 |
| Total Medical Medicare Standardized Payment Amount | 57408.35 |
| Average Age Of Beneficiaries | 69 |
| Number Of Beneficiaries Age Less65 | 74 |
| Number Of Beneficiaries Age 65 to 74 | 150 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | 21 |
| Number Of Female Beneficiaries | 173 |
| Number Of Male Beneficiaries | 119 |
| Number Of Non Hispanic White Beneficiaries | 249 |
| 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 | 243 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 49 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 4 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 19 |
| Percent Of With Chronic Kidney Disease | 28 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 21 |
| Percent Of With Depression | 20 |
| Percent Of With Diabetes | 28 |
| Percent Of With Hyperlipidemia | 58 |
| Percent Of With Hypertension | 64 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | |
| Average HCC Risk Score Of Beneficiaries | 1.4143 |