| National Provider Identifier [NPI]: | 1841264249 |
| Last Name Of The Provider | ARENCIBIA |
| First Name Of The Provider | JOSE |
| Middle Initial Of The Provider | M |
| Credentials Of The Provider | OD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 344 S MAIN ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | HIAWASSEE |
| Zip Code Of The Provider | 30546 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 2751 |
| Number Of Medicare Beneficiaries | 1031 |
| Total Submitted Charge Amount | 325676 |
| Total Medicare Allowed Amount | 253484.24 |
| Total Medicare Payment Amount | 174559.53 |
| Total Medicare Standardized Payment Amount | 187365.45 |
| 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 | 27 |
| Number Of Medical Services | 2751 |
| Number Of Medicare Beneficiaries With Medical Services | 1031 |
| Total Medical Submitted Charge Amount | 325676 |
| Total Medical Medicare Allowed Amount | 253484.24 |
| Total Medical Medicare Payment Amount | 174559.53 |
| Total Medical Medicare Standardized Payment Amount | 187365.45 |
| Average Age Of Beneficiaries | 74 |
| Number Of Beneficiaries Age Less65 | 46 |
| Number Of Beneficiaries Age 65 to 74 | 523 |
| Number Of Beneficiaries Age 75 to 84 | 362 |
| Number Of Beneficiaries Age Greater 84 | 100 |
| Number Of Female Beneficiaries | 604 |
| Number Of Male Beneficiaries | 427 |
| Number Of Non Hispanic White Beneficiaries | 1005 |
| Number Of Black or African American Beneficiaries | |
| Number Of AsianPacific Islander Beneficiaries | 0 |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 14 |
| Number Of Beneficiaries With Medicare Only Entitlement | 946 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 85 |
| Percent Of With Atrial Fibrillation | 11 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 3 |
| Percent Of With Cancer | 11 |
| Percent Of With Heart Failure | 9 |
| Percent Of With Chronic Kidney Disease | 16 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 11 |
| Percent Of With Depression | 15 |
| Percent Of With Diabetes | 24 |
| Percent Of With Hyperlipidemia | 65 |
| Percent Of With Hypertension | 66 |
| Percent Of With Ischemic Heart Disease | 25 |
| Percent Of With Osteoporosis | 9 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 32 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 3 |
| Average HCC Risk Score Of Beneficiaries | 0.9106 |