| National Provider Identifier [NPI]: | 1467423343 |
| Last Name Of The Provider | PLATT |
| First Name Of The Provider | LAWRENCE |
| Middle Initial Of The Provider | W |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3805A SPRING ST |
| Street Address 2 Of The Provider | SUITE 111 |
| City Of The Provider | RACINE |
| Zip Code Of The Provider | 534051600 |
| State Code Of The Provider | WI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 51 |
| Number Of Services | 3889 |
| Number Of Medicare Beneficiaries | 1639 |
| Total Submitted Charge Amount | 2124967 |
| Total Medicare Allowed Amount | 619684.95 |
| Total Medicare Payment Amount | 453458.18 |
| Total Medicare Standardized Payment Amount | 477685.48 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 4 |
| Number Of Drug Services | 162 |
| Number Of Medicare Beneficiaries With Drug Services | 37 |
| Total Drug Submitted ChargeAmount | 48282 |
| Total Drug Medicare AllowedAmount | 43556.1 |
| Total Drug Medicare PaymentAmount | 34095.46 |
| Total Drug Medicare Standardized Payment Amount | 34095.46 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 47 |
| Number Of Medical Services | 3727 |
| Number Of Medicare Beneficiaries With Medical Services | 1639 |
| Total Medical Submitted Charge Amount | 2076685 |
| Total Medical Medicare Allowed Amount | 576128.85 |
| Total Medical Medicare Payment Amount | 419362.72 |
| Total Medical Medicare Standardized Payment Amount | 443590.02 |
| Average Age Of Beneficiaries | 76 |
| Number Of Beneficiaries Age Less65 | 99 |
| Number Of Beneficiaries Age 65 to 74 | 627 |
| Number Of Beneficiaries Age 75 to 84 | 617 |
| Number Of Beneficiaries Age Greater 84 | 296 |
| Number Of Female Beneficiaries | 1025 |
| Number Of Male Beneficiaries | 614 |
| Number Of Non Hispanic White Beneficiaries | 1440 |
| Number Of Black or African American Beneficiaries | 107 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 68 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 1490 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 149 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 13 |
| Percent Of With Chronic Kidney Disease | 20 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 10 |
| Percent Of With Depression | 17 |
| Percent Of With Diabetes | 33 |
| Percent Of With Hyperlipidemia | 62 |
| Percent Of With Hypertension | 69 |
| Percent Of With Ischemic Heart Disease | 27 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1387 |