National Provider Identifier [NPI]: |
1104884915 |
Last Name Of The Provider |
ALCASABAS |
First Name Of The Provider |
ARNEL |
Middle Initial Of The Provider |
R |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
107 JAMES COLEMAN DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
VICTORIA |
Zip Code Of The Provider |
779043100 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
3018 |
Number Of Medicare Beneficiaries |
1235 |
Total Submitted Charge Amount |
308316 |
Total Medicare Allowed Amount |
250768.34 |
Total Medicare Payment Amount |
170563.95 |
Total Medicare Standardized Payment Amount |
183225.36 |
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 |
3018 |
Number Of Medicare Beneficiaries With Medical Services |
1235 |
Total Medical Submitted Charge Amount |
308316 |
Total Medical Medicare Allowed Amount |
250768.34 |
Total Medical Medicare Payment Amount |
170563.95 |
Total Medical Medicare Standardized Payment Amount |
183225.36 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
85 |
Number Of Beneficiaries Age 65 to 74 |
504 |
Number Of Beneficiaries Age 75 to 84 |
488 |
Number Of Beneficiaries Age Greater 84 |
158 |
Number Of Female Beneficiaries |
762 |
Number Of Male Beneficiaries |
473 |
Number Of Non Hispanic White Beneficiaries |
836 |
Number Of Black or African American Beneficiaries |
56 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
326 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1001 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
234 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
20 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
66 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
39 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
45 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1515 |