| National Provider Identifier [NPI]: | 1326194036 |
| Last Name Of The Provider | BROADWELL |
| First Name Of The Provider | LARRY |
| Middle Initial Of The Provider | K |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 820 JORDAN ST |
| Street Address 2 Of The Provider | SUITE 201 |
| City Of The Provider | SHREVEPORT |
| Zip Code Of The Provider | 711014518 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Rheumatology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 66 |
| Number Of Services | 126084 |
| Number Of Medicare Beneficiaries | 1286 |
| Total Submitted Charge Amount | 8305227.09 |
| Total Medicare Allowed Amount | 3307287.01 |
| Total Medicare Payment Amount | 2536052.44 |
| Total Medicare Standardized Payment Amount | 2575600.02 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 18 |
| Number Of Drug Services | 112661 |
| Number Of Medicare Beneficiaries With Drug Services | 524 |
| Total Drug Submitted ChargeAmount | 5115452.8 |
| Total Drug Medicare AllowedAmount | 2504526.04 |
| Total Drug Medicare PaymentAmount | 1928159.84 |
| Total Drug Medicare Standardized Payment Amount | 1928159.84 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 48 |
| Number Of Medical Services | 13423 |
| Number Of Medicare Beneficiaries With Medical Services | 1286 |
| Total Medical Submitted Charge Amount | 3189774.29 |
| Total Medical Medicare Allowed Amount | 802760.97 |
| Total Medical Medicare Payment Amount | 607892.6 |
| Total Medical Medicare Standardized Payment Amount | 647440.18 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 92 |
| Number Of Beneficiaries Age 65 to 74 | 588 |
| Number Of Beneficiaries Age 75 to 84 | 490 |
| Number Of Beneficiaries Age Greater 84 | 116 |
| Number Of Female Beneficiaries | 1074 |
| Number Of Male Beneficiaries | 212 |
| Number Of Non Hispanic White Beneficiaries | 1100 |
| Number Of Black or African American Beneficiaries | 157 |
| 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 | 12 |
| Number Of Beneficiaries With Medicare Only Entitlement | 1206 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 80 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 12 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 13 |
| Percent Of With Depression | 19 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 54 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 32 |
| Percent Of With Osteoporosis | 48 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 75 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 1 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1317 |