National Provider Identifier [NPI]: |
1245663061 |
Last Name Of The Provider |
MALDE |
First Name Of The Provider |
ELYSE |
Middle Initial Of The Provider |
M |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5705 RED BUG LAKE RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
WINTER SPRINGS |
Zip Code Of The Provider |
327084969 |
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 |
1143 |
Number Of Medicare Beneficiaries |
781 |
Total Submitted Charge Amount |
105219.74 |
Total Medicare Allowed Amount |
99770.42 |
Total Medicare Payment Amount |
66979.71 |
Total Medicare Standardized Payment Amount |
67382.65 |
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 |
1143 |
Number Of Medicare Beneficiaries With Medical Services |
781 |
Total Medical Submitted Charge Amount |
105219.74 |
Total Medical Medicare Allowed Amount |
99770.42 |
Total Medical Medicare Payment Amount |
66979.71 |
Total Medical Medicare Standardized Payment Amount |
67382.65 |
Average Age Of Beneficiaries |
81 |
Number Of Beneficiaries Age Less65 |
63 |
Number Of Beneficiaries Age 65 to 74 |
149 |
Number Of Beneficiaries Age 75 to 84 |
202 |
Number Of Beneficiaries Age Greater 84 |
367 |
Number Of Female Beneficiaries |
463 |
Number Of Male Beneficiaries |
318 |
Number Of Non Hispanic White Beneficiaries |
577 |
Number Of Black or African American Beneficiaries |
139 |
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 |
99 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
682 |
Percent Of With Atrial Fibrillation |
20 |
Percent Of With Alzheimers Disease or Dementia |
75 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
43 |
Percent Of With Chronic Kidney Disease |
44 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
67 |
Percent Of With Diabetes |
54 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
57 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
48 |
Percent Of With Schizophrenia Other PsychoticDisorders |
30 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.5043 |