National Provider Identifier [NPI]: |
1689613283 |
Last Name Of The Provider |
ISAACSON |
First Name Of The Provider |
NATHAN |
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 |
421 PARK PL |
Street Address 2 Of The Provider |
|
City Of The Provider |
WINDBER |
Zip Code Of The Provider |
159631718 |
State Code Of The Provider |
PA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
394 |
Number Of Medicare Beneficiaries |
268 |
Total Submitted Charge Amount |
41840 |
Total Medicare Allowed Amount |
36165.71 |
Total Medicare Payment Amount |
24986.61 |
Total Medicare Standardized Payment Amount |
26292.11 |
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 |
17 |
Number Of Medical Services |
394 |
Number Of Medicare Beneficiaries With Medical Services |
268 |
Total Medical Submitted Charge Amount |
41840 |
Total Medical Medicare Allowed Amount |
36165.71 |
Total Medical Medicare Payment Amount |
24986.61 |
Total Medical Medicare Standardized Payment Amount |
26292.11 |
Average Age Of Beneficiaries |
76 |
Number Of Beneficiaries Age Less65 |
29 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
71 |
Number Of Beneficiaries Age Greater 84 |
70 |
Number Of Female Beneficiaries |
169 |
Number Of Male Beneficiaries |
99 |
Number Of Non Hispanic White Beneficiaries |
|
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 |
220 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
48 |
Percent Of With Atrial Fibrillation |
13 |
Percent Of With Alzheimers Disease or Dementia |
11 |
Percent Of With Asthma |
|
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
16 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
10 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
31 |
Percent Of With Hyperlipidemia |
64 |
Percent Of With Hypertension |
73 |
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 |
|
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.1006 |