National Provider Identifier [NPI]: |
1649239229 |
Last Name Of The Provider |
TAO |
First Name Of The Provider |
ALVIN |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2600 GREENBUSH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAFAYETTE |
Zip Code Of The Provider |
479042479 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
2144 |
Number Of Medicare Beneficiaries |
1187 |
Total Submitted Charge Amount |
819918 |
Total Medicare Allowed Amount |
275941.27 |
Total Medicare Payment Amount |
198390.48 |
Total Medicare Standardized Payment Amount |
212834.33 |
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 |
21 |
Number Of Medical Services |
2144 |
Number Of Medicare Beneficiaries With Medical Services |
1187 |
Total Medical Submitted Charge Amount |
819918 |
Total Medical Medicare Allowed Amount |
275941.27 |
Total Medical Medicare Payment Amount |
198390.48 |
Total Medical Medicare Standardized Payment Amount |
212834.33 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
96 |
Number Of Beneficiaries Age 65 to 74 |
446 |
Number Of Beneficiaries Age 75 to 84 |
432 |
Number Of Beneficiaries Age Greater 84 |
213 |
Number Of Female Beneficiaries |
732 |
Number Of Male Beneficiaries |
455 |
Number Of Non Hispanic White Beneficiaries |
1120 |
Number Of Black or African American Beneficiaries |
15 |
Number Of AsianPacific Islander Beneficiaries |
15 |
Number Of Hispanic Beneficiaries |
21 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1066 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
121 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
7 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
24 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
71 |
Percent Of With Ischemic Heart Disease |
32 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0919 |