National Provider Identifier [NPI]: |
1861572349 |
Last Name Of The Provider |
OWERS |
First Name Of The Provider |
RICKY |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1455 E BERT KOUNS LOOP |
Street Address 2 Of The Provider |
#300 |
City Of The Provider |
SHREVEPORT |
Zip Code Of The Provider |
711055634 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Gynecological/Oncology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
103 |
Number Of Services |
1935 |
Number Of Medicare Beneficiaries |
253 |
Total Submitted Charge Amount |
527088 |
Total Medicare Allowed Amount |
174887.76 |
Total Medicare Payment Amount |
133293.96 |
Total Medicare Standardized Payment Amount |
140308.41 |
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 |
103 |
Number Of Medical Services |
1935 |
Number Of Medicare Beneficiaries With Medical Services |
253 |
Total Medical Submitted Charge Amount |
527088 |
Total Medical Medicare Allowed Amount |
174887.76 |
Total Medical Medicare Payment Amount |
133293.96 |
Total Medical Medicare Standardized Payment Amount |
140308.41 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
33 |
Number Of Beneficiaries Age 65 to 74 |
120 |
Number Of Beneficiaries Age 75 to 84 |
75 |
Number Of Beneficiaries Age Greater 84 |
25 |
Number Of Female Beneficiaries |
|
Number Of Male Beneficiaries |
|
Number Of Non Hispanic White Beneficiaries |
182 |
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 |
181 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
72 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
35 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
73 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.448 |