National Provider Identifier [NPI]: |
1295722908 |
Last Name Of The Provider |
ROBERTS |
First Name Of The Provider |
ELIZABETH |
Middle Initial Of The Provider |
P |
Credentials Of The Provider |
OD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1251 LAKELAND HILLS BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
LAKELAND |
Zip Code Of The Provider |
338054673 |
State Code Of The Provider |
FL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
12 |
Number Of Services |
383 |
Number Of Medicare Beneficiaries |
315 |
Total Submitted Charge Amount |
38788 |
Total Medicare Allowed Amount |
38395.53 |
Total Medicare Payment Amount |
24806.77 |
Total Medicare Standardized Payment Amount |
26912.12 |
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 |
12 |
Number Of Medical Services |
383 |
Number Of Medicare Beneficiaries With Medical Services |
315 |
Total Medical Submitted Charge Amount |
38788 |
Total Medical Medicare Allowed Amount |
38395.53 |
Total Medical Medicare Payment Amount |
24806.77 |
Total Medical Medicare Standardized Payment Amount |
26912.12 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
68 |
Number Of Beneficiaries Age 65 to 74 |
130 |
Number Of Beneficiaries Age 75 to 84 |
82 |
Number Of Beneficiaries Age Greater 84 |
35 |
Number Of Female Beneficiaries |
193 |
Number Of Male Beneficiaries |
122 |
Number Of Non Hispanic White Beneficiaries |
238 |
Number Of Black or African American Beneficiaries |
44 |
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 |
202 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
113 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
41 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
33 |
Percent Of With Osteoporosis |
12 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
35 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.2266 |