| National Provider Identifier [NPI]: | 1871591289 |
| Last Name Of The Provider | JEANSONNE |
| First Name Of The Provider | KEVIN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3704 NORTH BLVD |
| Street Address 2 Of The Provider | SUITE 1 |
| City Of The Provider | ALEXANDRIA |
| Zip Code Of The Provider | 713013606 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 198 |
| Number Of Services | 14513 |
| Number Of Medicare Beneficiaries | 7107 |
| Total Submitted Charge Amount | 1267469 |
| Total Medicare Allowed Amount | 328779.09 |
| Total Medicare Payment Amount | 253164.2 |
| Total Medicare Standardized Payment Amount | 264992.97 |
| 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 | 198 |
| Number Of Medical Services | 14513 |
| Number Of Medicare Beneficiaries With Medical Services | 7107 |
| Total Medical Submitted Charge Amount | 1267469 |
| Total Medical Medicare Allowed Amount | 328779.09 |
| Total Medical Medicare Payment Amount | 253164.2 |
| Total Medical Medicare Standardized Payment Amount | 264992.97 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 1759 |
| Number Of Beneficiaries Age 65 to 74 | 2597 |
| Number Of Beneficiaries Age 75 to 84 | 1934 |
| Number Of Beneficiaries Age Greater 84 | 817 |
| Number Of Female Beneficiaries | 4354 |
| Number Of Male Beneficiaries | 2753 |
| Number Of Non Hispanic White Beneficiaries | 5354 |
| Number Of Black or African American Beneficiaries | 1625 |
| Number Of AsianPacific Islander Beneficiaries | 28 |
| Number Of Hispanic Beneficiaries | 51 |
| Number Of American Indian Alaska Native Beneficiaries | 11 |
| Number Of Beneficiaries With Race Not Else where Classified | 38 |
| Number Of Beneficiaries With Medicare Only Entitlement | 4074 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 3033 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 19 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 12 |
| Percent Of With Heart Failure | 32 |
| Percent Of With Chronic Kidney Disease | 31 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 30 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 57 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 53 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 50 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 9 |
| Percent Of With Stroke | 12 |
| Average HCC Risk Score Of Beneficiaries | 1.6122 |