National Provider Identifier [NPI]: |
1548451420 |
Last Name Of The Provider |
WELLS |
First Name Of The Provider |
ADAM |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1514 JEFFERSON HWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
NEW ORLEANS |
Zip Code Of The Provider |
701212429 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Diagnostic Radiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
194 |
Number Of Services |
3130 |
Number Of Medicare Beneficiaries |
1935 |
Total Submitted Charge Amount |
234623 |
Total Medicare Allowed Amount |
98918.41 |
Total Medicare Payment Amount |
71118.86 |
Total Medicare Standardized Payment Amount |
72505.22 |
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 |
194 |
Number Of Medical Services |
3130 |
Number Of Medicare Beneficiaries With Medical Services |
1935 |
Total Medical Submitted Charge Amount |
234623 |
Total Medical Medicare Allowed Amount |
98918.41 |
Total Medical Medicare Payment Amount |
71118.86 |
Total Medical Medicare Standardized Payment Amount |
72505.22 |
Average Age Of Beneficiaries |
67 |
Number Of Beneficiaries Age Less65 |
675 |
Number Of Beneficiaries Age 65 to 74 |
655 |
Number Of Beneficiaries Age 75 to 84 |
390 |
Number Of Beneficiaries Age Greater 84 |
215 |
Number Of Female Beneficiaries |
1185 |
Number Of Male Beneficiaries |
750 |
Number Of Non Hispanic White Beneficiaries |
993 |
Number Of Black or African American Beneficiaries |
787 |
Number Of AsianPacific Islander Beneficiaries |
37 |
Number Of Hispanic Beneficiaries |
98 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1028 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
907 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
13 |
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 |
21 |
Percent Of With Depression |
34 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
2.1514 |