National Provider Identifier [NPI]: |
1366768434 |
Last Name Of The Provider |
SERRANO |
First Name Of The Provider |
STEPHEN |
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 |
524 DR MICHAEL DEBAKEY DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKE CHARLES |
Zip Code Of The Provider |
706015725 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
1553 |
Number Of Medicare Beneficiaries |
1122 |
Total Submitted Charge Amount |
1723552 |
Total Medicare Allowed Amount |
205231.13 |
Total Medicare Payment Amount |
157078.38 |
Total Medicare Standardized Payment Amount |
161917.47 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
4 |
Number Of Drug Services |
159 |
Number Of Medicare Beneficiaries With Drug Services |
18 |
Total Drug Submitted ChargeAmount |
686 |
Total Drug Medicare AllowedAmount |
29.27 |
Total Drug Medicare PaymentAmount |
21.39 |
Total Drug Medicare Standardized Payment Amount |
21.39 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
40 |
Number Of Medical Services |
1394 |
Number Of Medicare Beneficiaries With Medical Services |
1122 |
Total Medical Submitted Charge Amount |
1722866 |
Total Medical Medicare Allowed Amount |
205201.86 |
Total Medical Medicare Payment Amount |
157056.99 |
Total Medical Medicare Standardized Payment Amount |
161896.08 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
309 |
Number Of Beneficiaries Age 65 to 74 |
367 |
Number Of Beneficiaries Age 75 to 84 |
280 |
Number Of Beneficiaries Age Greater 84 |
166 |
Number Of Female Beneficiaries |
620 |
Number Of Male Beneficiaries |
502 |
Number Of Non Hispanic White Beneficiaries |
764 |
Number Of Black or African American Beneficiaries |
334 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
11 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
674 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
448 |
Percent Of With Atrial Fibrillation |
18 |
Percent Of With Alzheimers Disease or Dementia |
25 |
Percent Of With Asthma |
15 |
Percent Of With Cancer |
12 |
Percent Of With Heart Failure |
41 |
Percent Of With Chronic Kidney Disease |
39 |
Percent Of With Chronic Obstructive Pulmonary Disease |
34 |
Percent Of With Depression |
43 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
55 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
15 |
Average HCC Risk Score Of Beneficiaries |
2.16 |