| National Provider Identifier [NPI]: | 1639134901 |
| Last Name Of The Provider | ENNIS |
| First Name Of The Provider | BRUCE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 101 JUDGE TANNER BLVD |
| Street Address 2 Of The Provider | STE. 200 |
| City Of The Provider | COVINGTON |
| Zip Code Of The Provider | 704337503 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Cardiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 108 |
| Number Of Services | 3986 |
| Number Of Medicare Beneficiaries | 1372 |
| Total Submitted Charge Amount | 693016 |
| Total Medicare Allowed Amount | 267784.17 |
| Total Medicare Payment Amount | 203639.35 |
| Total Medicare Standardized Payment Amount | 218432.74 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 6 |
| Number Of Drug Services | 147 |
| Number Of Medicare Beneficiaries With Drug Services | 39 |
| Total Drug Submitted ChargeAmount | 13905 |
| Total Drug Medicare AllowedAmount | 7291.04 |
| Total Drug Medicare PaymentAmount | 5608.35 |
| Total Drug Medicare Standardized Payment Amount | 5608.35 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 3839 |
| Number Of Medicare Beneficiaries With Medical Services | 1372 |
| Total Medical Submitted Charge Amount | 679111 |
| Total Medical Medicare Allowed Amount | 260493.13 |
| Total Medical Medicare Payment Amount | 198031 |
| Total Medical Medicare Standardized Payment Amount | 212824.39 |
| Average Age Of Beneficiaries | 72 |
| Number Of Beneficiaries Age Less65 | 283 |
| Number Of Beneficiaries Age 65 to 74 | 470 |
| Number Of Beneficiaries Age 75 to 84 | 373 |
| Number Of Beneficiaries Age Greater 84 | 246 |
| Number Of Female Beneficiaries | 765 |
| Number Of Male Beneficiaries | 607 |
| Number Of Non Hispanic White Beneficiaries | 1098 |
| Number Of Black or African American Beneficiaries | 233 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 28 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 884 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 488 |
| Percent Of With Atrial Fibrillation | 26 |
| Percent Of With Alzheimers Disease or Dementia | 23 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 46 |
| Percent Of With Chronic Kidney Disease | 51 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 38 |
| Percent Of With Depression | 34 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 68 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 73 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 53 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 10 |
| Percent Of With Stroke | 13 |
| Average HCC Risk Score Of Beneficiaries | 2.3224 |