National Provider Identifier [NPI]: |
1104822311 |
Last Name Of The Provider |
MOCCIA |
First Name Of The Provider |
PAUL |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
O.D |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1103 S 4TH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATCHISON |
Zip Code Of The Provider |
660023109 |
State Code Of The Provider |
KS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
20 |
Number Of Services |
553 |
Number Of Medicare Beneficiaries |
412 |
Total Submitted Charge Amount |
44116 |
Total Medicare Allowed Amount |
37674.2 |
Total Medicare Payment Amount |
23987.9 |
Total Medicare Standardized Payment Amount |
26452.15 |
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 |
20 |
Number Of Medical Services |
553 |
Number Of Medicare Beneficiaries With Medical Services |
412 |
Total Medical Submitted Charge Amount |
44116 |
Total Medical Medicare Allowed Amount |
37674.2 |
Total Medical Medicare Payment Amount |
23987.9 |
Total Medical Medicare Standardized Payment Amount |
26452.15 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
45 |
Number Of Beneficiaries Age 65 to 74 |
131 |
Number Of Beneficiaries Age 75 to 84 |
128 |
Number Of Beneficiaries Age Greater 84 |
108 |
Number Of Female Beneficiaries |
277 |
Number Of Male Beneficiaries |
135 |
Number Of Non Hispanic White Beneficiaries |
373 |
Number Of Black or African American Beneficiaries |
26 |
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 |
253 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
159 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
32 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
30 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
17 |
Percent Of With Depression |
31 |
Percent Of With Diabetes |
36 |
Percent Of With Hyperlipidemia |
41 |
Percent Of With Hypertension |
67 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
41 |
Percent Of With Schizophrenia Other PsychoticDisorders |
15 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.259 |