National Provider Identifier [NPI]: |
1568463826 |
Last Name Of The Provider |
WILKINSON |
First Name Of The Provider |
MARK |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
200 HAWKINS DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
IOWA CITY |
Zip Code Of The Provider |
522421009 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
14 |
Number Of Services |
524 |
Number Of Medicare Beneficiaries |
496 |
Total Submitted Charge Amount |
92833 |
Total Medicare Allowed Amount |
20644.9 |
Total Medicare Payment Amount |
14182.16 |
Total Medicare Standardized Payment Amount |
15368.32 |
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 |
14 |
Number Of Medical Services |
524 |
Number Of Medicare Beneficiaries With Medical Services |
496 |
Total Medical Submitted Charge Amount |
92833 |
Total Medical Medicare Allowed Amount |
20644.9 |
Total Medical Medicare Payment Amount |
14182.16 |
Total Medical Medicare Standardized Payment Amount |
15368.32 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
80 |
Number Of Beneficiaries Age 65 to 74 |
137 |
Number Of Beneficiaries Age 75 to 84 |
126 |
Number Of Beneficiaries Age Greater 84 |
153 |
Number Of Female Beneficiaries |
297 |
Number Of Male Beneficiaries |
199 |
Number Of Non Hispanic White Beneficiaries |
470 |
Number Of Black or African American Beneficiaries |
13 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
412 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
84 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
3 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
17 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
42 |
Percent Of With Hypertension |
57 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
4 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2499 |