| National Provider Identifier [NPI]: | 1538108774 |
| Last Name Of The Provider | WHITE |
| First Name Of The Provider | KELLY |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1453 E BERT KOUNS INDUSTRIAL LOOP |
| Street Address 2 Of The Provider | RADIOLOGY |
| City Of The Provider | SHREVEPORT |
| Zip Code Of The Provider | 711056800 |
| 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 | 270 |
| Number Of Services | 4817 |
| Number Of Medicare Beneficiaries | 2654 |
| Total Submitted Charge Amount | 904455 |
| Total Medicare Allowed Amount | 197685.28 |
| Total Medicare Payment Amount | 151506.22 |
| Total Medicare Standardized Payment Amount | 158062.68 |
| 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 | 270 |
| Number Of Medical Services | 4817 |
| Number Of Medicare Beneficiaries With Medical Services | 2654 |
| Total Medical Submitted Charge Amount | 904455 |
| Total Medical Medicare Allowed Amount | 197685.28 |
| Total Medical Medicare Payment Amount | 151506.22 |
| Total Medical Medicare Standardized Payment Amount | 158062.68 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 448 |
| Number Of Beneficiaries Age 65 to 74 | 992 |
| Number Of Beneficiaries Age 75 to 84 | 793 |
| Number Of Beneficiaries Age Greater 84 | 421 |
| Number Of Female Beneficiaries | 1529 |
| Number Of Male Beneficiaries | 1125 |
| Number Of Non Hispanic White Beneficiaries | 1875 |
| Number Of Black or African American Beneficiaries | 723 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 24 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1837 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 817 |
| Percent Of With Atrial Fibrillation | 19 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 9 |
| Percent Of With Cancer | 16 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 45 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 33 |
| Percent Of With Depression | 32 |
| Percent Of With Diabetes | 41 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 56 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 57 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 7 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.9338 |