| National Provider Identifier [NPI]: | 1457310500 |
| Last Name Of The Provider | HOLCOMB |
| First Name Of The Provider | DIANA |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | F |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 670 SUTTON WAY |
| Street Address 2 Of The Provider | |
| City Of The Provider | GRASS VALLEY |
| Zip Code Of The Provider | 959455392 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 4 |
| Number Of Services | 1042 |
| Number Of Medicare Beneficiaries | 1014 |
| Total Submitted Charge Amount | 173790 |
| Total Medicare Allowed Amount | 141737.48 |
| Total Medicare Payment Amount | 110904.47 |
| Total Medicare Standardized Payment Amount | 105778.84 |
| 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 | 4 |
| Number Of Medical Services | 1042 |
| Number Of Medicare Beneficiaries With Medical Services | 1014 |
| Total Medical Submitted Charge Amount | 173790 |
| Total Medical Medicare Allowed Amount | 141737.48 |
| Total Medical Medicare Payment Amount | 110904.47 |
| Total Medical Medicare Standardized Payment Amount | 105778.84 |
| Average Age Of Beneficiaries | 82 |
| Number Of Beneficiaries Age Less65 | 69 |
| Number Of Beneficiaries Age 65 to 74 | 163 |
| Number Of Beneficiaries Age 75 to 84 | 296 |
| Number Of Beneficiaries Age Greater 84 | 486 |
| Number Of Female Beneficiaries | 687 |
| Number Of Male Beneficiaries | 327 |
| Number Of Non Hispanic White Beneficiaries | 880 |
| Number Of Black or African American Beneficiaries | 23 |
| Number Of AsianPacific Islander Beneficiaries | 20 |
| Number Of Hispanic Beneficiaries | 65 |
| Number Of American Indian Alaska Native Beneficiaries | 15 |
| Number Of Beneficiaries With Race Not Else where Classified | 11 |
| Number Of Beneficiaries With Medicare Only Entitlement | 142 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 872 |
| Percent Of With Atrial Fibrillation | 21 |
| Percent Of With Alzheimers Disease or Dementia | 70 |
| Percent Of With Asthma | 7 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 40 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 27 |
| Percent Of With Depression | 44 |
| Percent Of With Diabetes | 40 |
| Percent Of With Hyperlipidemia | 45 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 42 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 15 |
| Percent Of With Stroke | 19 |
| Average HCC Risk Score Of Beneficiaries | 2.2727 |