National Provider Identifier [NPI]: |
1386681351 |
Last Name Of The Provider |
LEWIS |
First Name Of The Provider |
LINDY |
Middle Initial Of The Provider |
H |
Credentials Of The Provider |
O D |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1000A VANN DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
383056001 |
State Code Of The Provider |
TN |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
693 |
Number Of Medicare Beneficiaries |
297 |
Total Submitted Charge Amount |
100720 |
Total Medicare Allowed Amount |
65863.33 |
Total Medicare Payment Amount |
45980.28 |
Total Medicare Standardized Payment Amount |
51083.81 |
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 |
21 |
Number Of Medical Services |
693 |
Number Of Medicare Beneficiaries With Medical Services |
297 |
Total Medical Submitted Charge Amount |
100720 |
Total Medical Medicare Allowed Amount |
65863.33 |
Total Medical Medicare Payment Amount |
45980.28 |
Total Medical Medicare Standardized Payment Amount |
51083.81 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
40 |
Number Of Beneficiaries Age 65 to 74 |
150 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
36 |
Number Of Female Beneficiaries |
186 |
Number Of Male Beneficiaries |
111 |
Number Of Non Hispanic White Beneficiaries |
229 |
Number Of Black or African American Beneficiaries |
|
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 |
230 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
67 |
Percent Of With Atrial Fibrillation |
5 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
14 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
33 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
74 |
Percent Of With Ischemic Heart Disease |
37 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.0947 |