| National Provider Identifier [NPI]: | 1528055480 |
| Last Name Of The Provider | FONTENOT |
| First Name Of The Provider | KERWIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1214 COOLIDGE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAFAYETTE |
| Zip Code Of The Provider | 705032621 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Anesthesiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 83 |
| Number Of Services | 763 |
| Number Of Medicare Beneficiaries | 666 |
| Total Submitted Charge Amount | 908571 |
| Total Medicare Allowed Amount | 85563.33 |
| Total Medicare Payment Amount | 65435.56 |
| Total Medicare Standardized Payment Amount | 67756.85 |
| 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 | 83 |
| Number Of Medical Services | 763 |
| Number Of Medicare Beneficiaries With Medical Services | 666 |
| Total Medical Submitted Charge Amount | 908571 |
| Total Medical Medicare Allowed Amount | 85563.33 |
| Total Medical Medicare Payment Amount | 65435.56 |
| Total Medical Medicare Standardized Payment Amount | 67756.85 |
| Average Age Of Beneficiaries | 71 |
| Number Of Beneficiaries Age Less65 | 132 |
| Number Of Beneficiaries Age 65 to 74 | 268 |
| Number Of Beneficiaries Age 75 to 84 | 188 |
| Number Of Beneficiaries Age Greater 84 | 78 |
| Number Of Female Beneficiaries | 365 |
| Number Of Male Beneficiaries | 301 |
| Number Of Non Hispanic White Beneficiaries | 493 |
| Number Of Black or African American Beneficiaries | 146 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 470 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 196 |
| Percent Of With Atrial Fibrillation | 16 |
| Percent Of With Alzheimers Disease or Dementia | 18 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 17 |
| Percent Of With Heart Failure | 30 |
| Percent Of With Chronic Kidney Disease | 36 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 22 |
| Percent Of With Depression | 31 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 52 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 51 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 8 |
| Percent Of With Stroke | 9 |
| Average HCC Risk Score Of Beneficiaries | 1.9474 |