National Provider Identifier [NPI]: |
1265537666 |
Last Name Of The Provider |
YOUNG |
First Name Of The Provider |
MICHELINE |
Middle Initial Of The Provider |
D |
Credentials Of The Provider |
OD |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
304 E HIGHWAY 190 |
Street Address 2 Of The Provider |
|
City Of The Provider |
COPPERAS COVE |
Zip Code Of The Provider |
765222939 |
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 |
16 |
Number Of Services |
858 |
Number Of Medicare Beneficiaries |
377 |
Total Submitted Charge Amount |
80547.65 |
Total Medicare Allowed Amount |
63447.42 |
Total Medicare Payment Amount |
44793.59 |
Total Medicare Standardized Payment Amount |
47903.37 |
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 |
16 |
Number Of Medical Services |
858 |
Number Of Medicare Beneficiaries With Medical Services |
377 |
Total Medical Submitted Charge Amount |
80547.65 |
Total Medical Medicare Allowed Amount |
63447.42 |
Total Medical Medicare Payment Amount |
44793.59 |
Total Medical Medicare Standardized Payment Amount |
47903.37 |
Average Age Of Beneficiaries |
70 |
Number Of Beneficiaries Age Less65 |
55 |
Number Of Beneficiaries Age 65 to 74 |
200 |
Number Of Beneficiaries Age 75 to 84 |
101 |
Number Of Beneficiaries Age Greater 84 |
21 |
Number Of Female Beneficiaries |
227 |
Number Of Male Beneficiaries |
150 |
Number Of Non Hispanic White Beneficiaries |
307 |
Number Of Black or African American Beneficiaries |
20 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
34 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
315 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
62 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
19 |
Percent Of With Diabetes |
34 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9736 |