National Provider Identifier [NPI]: |
1700805801 |
Last Name Of The Provider |
ERWIN |
First Name Of The Provider |
RUSSELL |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
NP |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3600 FLORIDA BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
BATON ROUGE |
Zip Code Of The Provider |
708063842 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Nurse Practitioner |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
9 |
Number Of Services |
3327 |
Number Of Medicare Beneficiaries |
474 |
Total Submitted Charge Amount |
352301 |
Total Medicare Allowed Amount |
186546.55 |
Total Medicare Payment Amount |
137712.76 |
Total Medicare Standardized Payment Amount |
175478.61 |
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 |
9 |
Number Of Medical Services |
3327 |
Number Of Medicare Beneficiaries With Medical Services |
474 |
Total Medical Submitted Charge Amount |
352301 |
Total Medical Medicare Allowed Amount |
186546.55 |
Total Medical Medicare Payment Amount |
137712.76 |
Total Medical Medicare Standardized Payment Amount |
175478.61 |
Average Age Of Beneficiaries |
78 |
Number Of Beneficiaries Age Less65 |
47 |
Number Of Beneficiaries Age 65 to 74 |
113 |
Number Of Beneficiaries Age 75 to 84 |
159 |
Number Of Beneficiaries Age Greater 84 |
155 |
Number Of Female Beneficiaries |
336 |
Number Of Male Beneficiaries |
138 |
Number Of Non Hispanic White Beneficiaries |
403 |
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 |
150 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
324 |
Percent Of With Atrial Fibrillation |
19 |
Percent Of With Alzheimers Disease or Dementia |
60 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
35 |
Percent Of With Chronic Kidney Disease |
42 |
Percent Of With Chronic Obstructive Pulmonary Disease |
32 |
Percent Of With Depression |
51 |
Percent Of With Diabetes |
42 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
46 |
Percent Of With Osteoporosis |
13 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
51 |
Percent Of With Schizophrenia Other PsychoticDisorders |
21 |
Percent Of With Stroke |
19 |
Average HCC Risk Score Of Beneficiaries |
2.0435 |