National Provider Identifier [NPI]: |
1760796577 |
Last Name Of The Provider |
BUISSON |
First Name Of The Provider |
LAURA |
Middle Initial Of The Provider |
L |
Credentials Of The Provider |
OD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
900 N CANAL BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
THIBODAUX |
Zip Code Of The Provider |
703018096 |
State Code Of The Provider |
LA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
22 |
Number Of Services |
1228 |
Number Of Medicare Beneficiaries |
386 |
Total Submitted Charge Amount |
133795 |
Total Medicare Allowed Amount |
101754.96 |
Total Medicare Payment Amount |
72237.21 |
Total Medicare Standardized Payment Amount |
78822.08 |
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 |
22 |
Number Of Medical Services |
1228 |
Number Of Medicare Beneficiaries With Medical Services |
386 |
Total Medical Submitted Charge Amount |
133795 |
Total Medical Medicare Allowed Amount |
101754.96 |
Total Medical Medicare Payment Amount |
72237.21 |
Total Medical Medicare Standardized Payment Amount |
78822.08 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
144 |
Number Of Beneficiaries Age 75 to 84 |
121 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
243 |
Number Of Male Beneficiaries |
143 |
Number Of Non Hispanic White Beneficiaries |
254 |
Number Of Black or African American Beneficiaries |
117 |
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 |
159 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
65 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2172 |