National Provider Identifier [NPI]: |
1972639680 |
Last Name Of The Provider |
LEDUC |
First Name Of The Provider |
LAURA |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
67 CREEKSIDE PARK CT |
Street Address 2 Of The Provider |
|
City Of The Provider |
GREENVILLE |
Zip Code Of The Provider |
296154810 |
State Code Of The Provider |
SC |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Anesthesiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
51 |
Number Of Services |
115 |
Number Of Medicare Beneficiaries |
104 |
Total Submitted Charge Amount |
89599 |
Total Medicare Allowed Amount |
19353.92 |
Total Medicare Payment Amount |
15138.58 |
Total Medicare Standardized Payment Amount |
15718.48 |
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 |
51 |
Number Of Medical Services |
115 |
Number Of Medicare Beneficiaries With Medical Services |
104 |
Total Medical Submitted Charge Amount |
89599 |
Total Medical Medicare Allowed Amount |
19353.92 |
Total Medical Medicare Payment Amount |
15138.58 |
Total Medical Medicare Standardized Payment Amount |
15718.48 |
Average Age Of Beneficiaries |
66 |
Number Of Beneficiaries Age Less65 |
37 |
Number Of Beneficiaries Age 65 to 74 |
36 |
Number Of Beneficiaries Age 75 to 84 |
|
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
57 |
Number Of Male Beneficiaries |
47 |
Number Of Non Hispanic White Beneficiaries |
92 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
0 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
66 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
24 |
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
11 |
Percent Of With Cancer |
17 |
Percent Of With Heart Failure |
25 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
18 |
Percent Of With Depression |
36 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
41 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
12 |
Average HCC Risk Score Of Beneficiaries |
1.7136 |