National Provider Identifier [NPI]: |
1891868840 |
Last Name Of The Provider |
ACOSTA |
First Name Of The Provider |
MARC |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3100 HOUMA BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
METAIRIE |
Zip Code Of The Provider |
700065406 |
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 |
27 |
Number Of Services |
717 |
Number Of Medicare Beneficiaries |
129 |
Total Submitted Charge Amount |
42510 |
Total Medicare Allowed Amount |
38246.13 |
Total Medicare Payment Amount |
27865.74 |
Total Medicare Standardized Payment Amount |
28794.32 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
81 |
Number Of Medicare Beneficiaries With Drug Services |
35 |
Total Drug Submitted ChargeAmount |
1165 |
Total Drug Medicare AllowedAmount |
461.06 |
Total Drug Medicare PaymentAmount |
405.32 |
Total Drug Medicare Standardized Payment Amount |
405.32 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
20 |
Number Of Medical Services |
636 |
Number Of Medicare Beneficiaries With Medical Services |
129 |
Total Medical Submitted Charge Amount |
41345 |
Total Medical Medicare Allowed Amount |
37785.07 |
Total Medical Medicare Payment Amount |
27460.42 |
Total Medical Medicare Standardized Payment Amount |
28389 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
44 |
Number Of Beneficiaries Age 65 to 74 |
44 |
Number Of Beneficiaries Age 75 to 84 |
22 |
Number Of Beneficiaries Age Greater 84 |
19 |
Number Of Female Beneficiaries |
78 |
Number Of Male Beneficiaries |
51 |
Number Of Non Hispanic White Beneficiaries |
111 |
Number Of Black or African American Beneficiaries |
|
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 |
0 |
Number Of Beneficiaries With Medicare Only Entitlement |
89 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
40 |
Percent Of With Atrial Fibrillation |
|
Percent Of With Alzheimers Disease or Dementia |
|
Percent Of With Asthma |
|
Percent Of With Cancer |
|
Percent Of With Heart Failure |
11 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
19 |
Percent Of With Hyperlipidemia |
30 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
23 |
Percent Of With Osteoporosis |
|
Percent Of With Rheumatoid Arthritis Osteoarthritis |
43 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.014 |