National Provider Identifier [NPI]: |
1598762197 |
Last Name Of The Provider |
CONSTABLE |
First Name Of The Provider |
JOSEPH |
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 |
5421 LA SIERRA DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
DALLAS |
Zip Code Of The Provider |
752314107 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
1268 |
Number Of Medicare Beneficiaries |
606 |
Total Submitted Charge Amount |
197796 |
Total Medicare Allowed Amount |
107647.38 |
Total Medicare Payment Amount |
73287.6 |
Total Medicare Standardized Payment Amount |
77222.41 |
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 |
29 |
Number Of Medical Services |
1268 |
Number Of Medicare Beneficiaries With Medical Services |
606 |
Total Medical Submitted Charge Amount |
197796 |
Total Medical Medicare Allowed Amount |
107647.38 |
Total Medical Medicare Payment Amount |
73287.6 |
Total Medical Medicare Standardized Payment Amount |
77222.41 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
27 |
Number Of Beneficiaries Age 65 to 74 |
261 |
Number Of Beneficiaries Age 75 to 84 |
231 |
Number Of Beneficiaries Age Greater 84 |
87 |
Number Of Female Beneficiaries |
384 |
Number Of Male Beneficiaries |
222 |
Number Of Non Hispanic White Beneficiaries |
474 |
Number Of Black or African American Beneficiaries |
45 |
Number Of AsianPacific Islander Beneficiaries |
31 |
Number Of Hispanic Beneficiaries |
38 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
513 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
93 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
12 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
60 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
44 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
6 |
Average HCC Risk Score Of Beneficiaries |
1.0698 |