National Provider Identifier [NPI]: |
1144238890 |
Last Name Of The Provider |
TAFFORA |
First Name Of The Provider |
JAMIE |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
OD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
303 W 89TH AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
MERRILLVILLE |
Zip Code Of The Provider |
464106294 |
State Code Of The Provider |
IN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
289 |
Number Of Medicare Beneficiaries |
249 |
Total Submitted Charge Amount |
29480 |
Total Medicare Allowed Amount |
21941.88 |
Total Medicare Payment Amount |
13995.25 |
Total Medicare Standardized Payment Amount |
15053.55 |
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 |
17 |
Number Of Medical Services |
289 |
Number Of Medicare Beneficiaries With Medical Services |
249 |
Total Medical Submitted Charge Amount |
29480 |
Total Medical Medicare Allowed Amount |
21941.88 |
Total Medical Medicare Payment Amount |
13995.25 |
Total Medical Medicare Standardized Payment Amount |
15053.55 |
Average Age Of Beneficiaries |
68 |
Number Of Beneficiaries Age Less65 |
60 |
Number Of Beneficiaries Age 65 to 74 |
106 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
12 |
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
95 |
Number Of Non Hispanic White Beneficiaries |
182 |
Number Of Black or African American Beneficiaries |
45 |
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 |
170 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
79 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
19 |
Percent Of With Chronic Kidney Disease |
24 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
53 |
Percent Of With Hypertension |
68 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
8 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0902 |