National Provider Identifier [NPI]: |
1487882759 |
Last Name Of The Provider |
THOMSON |
First Name Of The Provider |
ERICA |
Middle Initial Of The Provider |
S |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1202 S TYLER ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
COVINGTON |
Zip Code Of The Provider |
704332330 |
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 |
13 |
Number Of Services |
969 |
Number Of Medicare Beneficiaries |
332 |
Total Submitted Charge Amount |
307307 |
Total Medicare Allowed Amount |
96711.7 |
Total Medicare Payment Amount |
75585.97 |
Total Medicare Standardized Payment Amount |
78347.78 |
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 |
13 |
Number Of Medical Services |
969 |
Number Of Medicare Beneficiaries With Medical Services |
332 |
Total Medical Submitted Charge Amount |
307307 |
Total Medical Medicare Allowed Amount |
96711.7 |
Total Medical Medicare Payment Amount |
75585.97 |
Total Medical Medicare Standardized Payment Amount |
78347.78 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
63 |
Number Of Beneficiaries Age 65 to 74 |
86 |
Number Of Beneficiaries Age 75 to 84 |
103 |
Number Of Beneficiaries Age Greater 84 |
80 |
Number Of Female Beneficiaries |
196 |
Number Of Male Beneficiaries |
136 |
Number Of Non Hispanic White Beneficiaries |
277 |
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 |
217 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
115 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
24 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
18 |
Percent Of With Heart Failure |
49 |
Percent Of With Chronic Kidney Disease |
63 |
Percent Of With Chronic Obstructive Pulmonary Disease |
35 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
68 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
54 |
Percent Of With Schizophrenia Other PsychoticDisorders |
10 |
Percent Of With Stroke |
14 |
Average HCC Risk Score Of Beneficiaries |
2.4114 |