National Provider Identifier [NPI]: |
1700848777 |
Last Name Of The Provider |
BRYAN |
First Name Of The Provider |
DAVID |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1666 E BERT KOUNS INDUSTRIAL LOOP |
Street Address 2 Of The Provider |
STE 235 |
City Of The Provider |
SHREVEPORT |
Zip Code Of The Provider |
711055714 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
33 |
Number Of Services |
1403 |
Number Of Medicare Beneficiaries |
548 |
Total Submitted Charge Amount |
360723 |
Total Medicare Allowed Amount |
147123.4 |
Total Medicare Payment Amount |
104548.16 |
Total Medicare Standardized Payment Amount |
112969.3 |
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 |
33 |
Number Of Medical Services |
1403 |
Number Of Medicare Beneficiaries With Medical Services |
548 |
Total Medical Submitted Charge Amount |
360723 |
Total Medical Medicare Allowed Amount |
147123.4 |
Total Medical Medicare Payment Amount |
104548.16 |
Total Medical Medicare Standardized Payment Amount |
112969.3 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
48 |
Number Of Beneficiaries Age 65 to 74 |
243 |
Number Of Beneficiaries Age 75 to 84 |
184 |
Number Of Beneficiaries Age Greater 84 |
73 |
Number Of Female Beneficiaries |
348 |
Number Of Male Beneficiaries |
200 |
Number Of Non Hispanic White Beneficiaries |
464 |
Number Of Black or African American Beneficiaries |
72 |
Number Of AsianPacific Islander Beneficiaries |
0 |
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 |
482 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
66 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
19 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
17 |
Percent Of With Diabetes |
39 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
47 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1216 |