National Provider Identifier [NPI]: |
1720067549 |
Last Name Of The Provider |
MORITZ |
First Name Of The Provider |
NORBERT |
Middle Initial Of The Provider |
F |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
733 W CLAIREMONT AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
EAU CLAIRE |
Zip Code Of The Provider |
547016101 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1193 |
Number Of Medicare Beneficiaries |
988 |
Total Submitted Charge Amount |
231533 |
Total Medicare Allowed Amount |
126804.35 |
Total Medicare Payment Amount |
77407.23 |
Total Medicare Standardized Payment Amount |
82368.93 |
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 |
1193 |
Number Of Medicare Beneficiaries With Medical Services |
988 |
Total Medical Submitted Charge Amount |
231533 |
Total Medical Medicare Allowed Amount |
126804.35 |
Total Medical Medicare Payment Amount |
77407.23 |
Total Medical Medicare Standardized Payment Amount |
82368.93 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
120 |
Number Of Beneficiaries Age 65 to 74 |
504 |
Number Of Beneficiaries Age 75 to 84 |
268 |
Number Of Beneficiaries Age Greater 84 |
96 |
Number Of Female Beneficiaries |
528 |
Number Of Male Beneficiaries |
460 |
Number Of Non Hispanic White Beneficiaries |
958 |
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 |
19 |
Number Of Beneficiaries With Medicare Only Entitlement |
825 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
163 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
4 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
15 |
Percent Of With Chronic Obstructive Pulmonary Disease |
8 |
Percent Of With Depression |
16 |
Percent Of With Diabetes |
30 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
48 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
2 |
Average HCC Risk Score Of Beneficiaries |
0.9335 |