| National Provider Identifier [NPI]: | 1710196548 |
| Last Name Of The Provider | BANKSTON |
| First Name Of The Provider | LARRY |
| Middle Initial Of The Provider | S |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 8080 BLUEBONNET BLVD |
| Street Address 2 Of The Provider | SUITE 1000 |
| City Of The Provider | BATON ROUGE |
| Zip Code Of The Provider | 708107827 |
| State Code Of The Provider | LA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Orthopedic Surgery |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 78 |
| Number Of Services | 1356 |
| Number Of Medicare Beneficiaries | 288 |
| Total Submitted Charge Amount | 472100 |
| Total Medicare Allowed Amount | 131894.8 |
| Total Medicare Payment Amount | 98651.9 |
| Total Medicare Standardized Payment Amount | 106593.55 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 2 |
| Number Of Drug Services | 119 |
| Number Of Medicare Beneficiaries With Drug Services | 94 |
| Total Drug Submitted ChargeAmount | 2837 |
| Total Drug Medicare AllowedAmount | 676.49 |
| Total Drug Medicare PaymentAmount | 519.26 |
| Total Drug Medicare Standardized Payment Amount | 519.26 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 76 |
| Number Of Medical Services | 1237 |
| Number Of Medicare Beneficiaries With Medical Services | 288 |
| Total Medical Submitted Charge Amount | 469263 |
| Total Medical Medicare Allowed Amount | 131218.31 |
| Total Medical Medicare Payment Amount | 98132.64 |
| Total Medical Medicare Standardized Payment Amount | 106074.29 |
| Average Age Of Beneficiaries | 70 |
| Number Of Beneficiaries Age Less65 | 54 |
| Number Of Beneficiaries Age 65 to 74 | 136 |
| Number Of Beneficiaries Age 75 to 84 | 70 |
| Number Of Beneficiaries Age Greater 84 | 28 |
| Number Of Female Beneficiaries | 174 |
| Number Of Male Beneficiaries | 114 |
| Number Of Non Hispanic White Beneficiaries | 221 |
| 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 | 227 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 61 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 14 |
| Percent Of With Chronic Kidney Disease | 22 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 28 |
| Percent Of With Diabetes | 31 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 38 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 68 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 5 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.3037 |