| National Provider Identifier [NPI]: | 1831487610 |
| Last Name Of The Provider | TRIPLETT |
| First Name Of The Provider | ALICIA |
| Middle Initial Of The Provider | U |
| Credentials Of The Provider | OD |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 900 W SPRINGFIELD RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | TAYLORVILLE |
| Zip Code Of The Provider | 625681299 |
| State Code Of The Provider | IL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 24 |
| Number Of Services | 1653 |
| Number Of Medicare Beneficiaries | 578 |
| Total Submitted Charge Amount | 90586.8 |
| Total Medicare Allowed Amount | 89591.95 |
| Total Medicare Payment Amount | 67492.38 |
| Total Medicare Standardized Payment Amount | 69538.66 |
| 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 | 24 |
| Number Of Medical Services | 1653 |
| Number Of Medicare Beneficiaries With Medical Services | 578 |
| Total Medical Submitted Charge Amount | 90586.8 |
| Total Medical Medicare Allowed Amount | 89591.95 |
| Total Medical Medicare Payment Amount | 67492.38 |
| Total Medical Medicare Standardized Payment Amount | 69538.66 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 145 |
| Number Of Beneficiaries Age 65 to 74 | 91 |
| Number Of Beneficiaries Age 75 to 84 | 139 |
| Number Of Beneficiaries Age Greater 84 | 203 |
| Number Of Female Beneficiaries | 379 |
| Number Of Male Beneficiaries | 199 |
| Number Of Non Hispanic White Beneficiaries | 552 |
| 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 | 159 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 419 |
| Percent Of With Atrial Fibrillation | 13 |
| Percent Of With Alzheimers Disease or Dementia | 50 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 34 |
| Percent Of With Chronic Kidney Disease | 24 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 18 |
| Percent Of With Depression | 45 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 43 |
| Percent Of With Hypertension | 70 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 12 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 36 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 22 |
| Percent Of With Stroke | 7 |
| Average HCC Risk Score Of Beneficiaries | 1.6028 |