National Provider Identifier [NPI]: |
1972586527 |
Last Name Of The Provider |
KEMP |
First Name Of The Provider |
SUSAN |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1453 E BERT KOUNS LOOP |
Street Address 2 Of The Provider |
SUITE 221 |
City Of The Provider |
SHREVEPORT |
Zip Code Of The Provider |
711056800 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
39 |
Number Of Services |
2432 |
Number Of Medicare Beneficiaries |
451 |
Total Submitted Charge Amount |
263934 |
Total Medicare Allowed Amount |
123985.69 |
Total Medicare Payment Amount |
84647.48 |
Total Medicare Standardized Payment Amount |
92764.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
12 |
Number Of Drug Services |
646 |
Number Of Medicare Beneficiaries With Drug Services |
135 |
Total Drug Submitted ChargeAmount |
10400 |
Total Drug Medicare AllowedAmount |
5471.71 |
Total Drug Medicare PaymentAmount |
5230.2 |
Total Drug Medicare Standardized Payment Amount |
5230.2 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
27 |
Number Of Medical Services |
1786 |
Number Of Medicare Beneficiaries With Medical Services |
451 |
Total Medical Submitted Charge Amount |
253534 |
Total Medical Medicare Allowed Amount |
118513.98 |
Total Medical Medicare Payment Amount |
79417.28 |
Total Medical Medicare Standardized Payment Amount |
87534.63 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
106 |
Number Of Beneficiaries Age 65 to 74 |
180 |
Number Of Beneficiaries Age 75 to 84 |
111 |
Number Of Beneficiaries Age Greater 84 |
54 |
Number Of Female Beneficiaries |
307 |
Number Of Male Beneficiaries |
144 |
Number Of Non Hispanic White Beneficiaries |
279 |
Number Of Black or African American Beneficiaries |
161 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
313 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
138 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
22 |
Percent Of With Chronic Kidney Disease |
31 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
44 |
Percent Of With Osteoporosis |
11 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.9533 |