| National Provider Identifier [NPI]: | 1659469542 |
| Last Name Of The Provider | BREAUX |
| First Name Of The Provider | EDWARD |
| Middle Initial Of The Provider | F |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1016 COOLIDGE BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAFAYETTE |
| Zip Code Of The Provider | 705032436 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Urology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 110 |
| Number Of Services | 6303 |
| Number Of Medicare Beneficiaries | 813 |
| Total Submitted Charge Amount | 1042143.65 |
| Total Medicare Allowed Amount | 300820.49 |
| Total Medicare Payment Amount | 220395.26 |
| Total Medicare Standardized Payment Amount | 235673.09 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 8 |
| Number Of Drug Services | 1071 |
| Number Of Medicare Beneficiaries With Drug Services | 51 |
| Total Drug Submitted ChargeAmount | 337725 |
| Total Drug Medicare AllowedAmount | 60051.26 |
| Total Drug Medicare PaymentAmount | 44958.92 |
| Total Drug Medicare Standardized Payment Amount | 44958.92 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 102 |
| Number Of Medical Services | 5232 |
| Number Of Medicare Beneficiaries With Medical Services | 813 |
| Total Medical Submitted Charge Amount | 704418.65 |
| Total Medical Medicare Allowed Amount | 240769.23 |
| Total Medical Medicare Payment Amount | 175436.34 |
| Total Medical Medicare Standardized Payment Amount | 190714.17 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 38 |
| Number Of Beneficiaries Age 65 to 74 | 369 |
| Number Of Beneficiaries Age 75 to 84 | 325 |
| Number Of Beneficiaries Age Greater 84 | 81 |
| Number Of Female Beneficiaries | 148 |
| Number Of Male Beneficiaries | 665 |
| Number Of Non Hispanic White Beneficiaries | 737 |
| Number Of Black or African American Beneficiaries | 44 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 20 |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 757 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 56 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 22 |
| Percent Of With Heart Failure | 15 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 12 |
| Percent Of With Diabetes | 26 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 65 |
| Percent Of With Ischemic Heart Disease | 49 |
| Percent Of With Osteoporosis | 4 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 34 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.0404 |