| National Provider Identifier [NPI]: | 1114230828 |
| Last Name Of The Provider | LANDRY |
| First Name Of The Provider | JAMIE |
| Middle Initial Of The Provider | C |
| Credentials Of The Provider | PH.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 70452 HIGHWAY 21 |
| Street Address 2 Of The Provider | SUITE 200 #116 |
| City Of The Provider | COVINGTON |
| Zip Code Of The Provider | 704338116 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Clinical Psychologist |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 5 |
| Number Of Services | 1003 |
| Number Of Medicare Beneficiaries | 152 |
| Total Submitted Charge Amount | 94490 |
| Total Medicare Allowed Amount | 82617.66 |
| Total Medicare Payment Amount | 62323.2 |
| Total Medicare Standardized Payment Amount | 19527.75 |
| 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 | 5 |
| Number Of Medical Services | 1003 |
| Number Of Medicare Beneficiaries With Medical Services | 152 |
| Total Medical Submitted Charge Amount | 94490 |
| Total Medical Medicare Allowed Amount | 82617.66 |
| Total Medical Medicare Payment Amount | 62323.2 |
| Total Medical Medicare Standardized Payment Amount | 19527.75 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 30 |
| Number Of Beneficiaries Age 65 to 74 | 30 |
| Number Of Beneficiaries Age 75 to 84 | 47 |
| Number Of Beneficiaries Age Greater 84 | 45 |
| Number Of Female Beneficiaries | 109 |
| Number Of Male Beneficiaries | 43 |
| Number Of Non Hispanic White Beneficiaries | 123 |
| 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 | 21 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 131 |
| Percent Of With Atrial Fibrillation | 23 |
| Percent Of With Alzheimers Disease or Dementia | 67 |
| Percent Of With Asthma | 11 |
| Percent Of With Cancer | |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 50 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 75 |
| Percent Of With Diabetes | 59 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 13 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 61 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 43 |
| Percent Of With Stroke | 20 |
| Average HCC Risk Score Of Beneficiaries | 2.8712 |