| National Provider Identifier [NPI]: | 1538100805 |
| Last Name Of The Provider | HEBERT |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1453 E BERT KOUNS INDUSTRIAL LOOP |
| Street Address 2 Of The Provider | RADIOLOGY DEPARTMENT |
| 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 | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 173 |
| Number Of Services | 6848 |
| Number Of Medicare Beneficiaries | 4108 |
| Total Submitted Charge Amount | 795067 |
| Total Medicare Allowed Amount | 180182.11 |
| Total Medicare Payment Amount | 141309.65 |
| Total Medicare Standardized Payment Amount | 148388.52 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 1 |
| Number Of Drug Services | 260 |
| Number Of Medicare Beneficiaries With Drug Services | 14 |
| Total Drug Submitted ChargeAmount | 1820 |
| Total Drug Medicare AllowedAmount | 577.13 |
| Total Drug Medicare PaymentAmount | 317.43 |
| Total Drug Medicare Standardized Payment Amount | 317.43 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 172 |
| Number Of Medical Services | 6588 |
| Number Of Medicare Beneficiaries With Medical Services | 4108 |
| Total Medical Submitted Charge Amount | 793247 |
| Total Medical Medicare Allowed Amount | 179604.98 |
| Total Medical Medicare Payment Amount | 140992.22 |
| Total Medical Medicare Standardized Payment Amount | 148071.09 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 684 |
| Number Of Beneficiaries Age 65 to 74 | 1595 |
| Number Of Beneficiaries Age 75 to 84 | 1239 |
| Number Of Beneficiaries Age Greater 84 | 590 |
| Number Of Female Beneficiaries | 2844 |
| Number Of Male Beneficiaries | 1264 |
| Number Of Non Hispanic White Beneficiaries | 2886 |
| Number Of Black or African American Beneficiaries | 1148 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 30 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 26 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2894 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1214 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 14 |
| Percent Of With Heart Failure | 29 |
| Percent Of With Chronic Kidney Disease | 35 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 38 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 55 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.5721 |