| National Provider Identifier [NPI]: | 1700863214 |
| Last Name Of The Provider | MANGAN |
| First Name Of The Provider | RICHARD |
| Middle Initial Of The Provider | B |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1935 BLUEGRASS AVE |
| Street Address 2 Of The Provider | SUITE 200 |
| City Of The Provider | LOUISVILLE |
| Zip Code Of The Provider | 402151179 |
| State Code Of The Provider | KY |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 31 |
| Number Of Services | 3393 |
| Number Of Medicare Beneficiaries | 1948 |
| Total Submitted Charge Amount | 327423.8 |
| Total Medicare Allowed Amount | 260089.6 |
| Total Medicare Payment Amount | 199209 |
| Total Medicare Standardized Payment Amount | 216157.75 |
| 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 | 31 |
| Number Of Medical Services | 3393 |
| Number Of Medicare Beneficiaries With Medical Services | 1948 |
| Total Medical Submitted Charge Amount | 327423.8 |
| Total Medical Medicare Allowed Amount | 260089.6 |
| Total Medical Medicare Payment Amount | 199209 |
| Total Medical Medicare Standardized Payment Amount | 216157.75 |
| Average Age Of Beneficiaries | 78 |
| Number Of Beneficiaries Age Less65 | 165 |
| Number Of Beneficiaries Age 65 to 74 | 587 |
| Number Of Beneficiaries Age 75 to 84 | 621 |
| Number Of Beneficiaries Age Greater 84 | 575 |
| Number Of Female Beneficiaries | 1372 |
| Number Of Male Beneficiaries | 576 |
| Number Of Non Hispanic White Beneficiaries | 1685 |
| Number Of Black or African American Beneficiaries | 219 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 13 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 20 |
| Number Of Beneficiaries With Medicare Only Entitlement | 758 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1190 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 53 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 7 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 33 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 26 |
| Percent Of With Depression | 40 |
| Percent Of With Diabetes | 42 |
| Percent Of With Hyperlipidemia | 49 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 44 |
| Percent Of With Osteoporosis | 11 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 45 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 22 |
| Percent Of With Stroke | 11 |
| Average HCC Risk Score Of Beneficiaries | 1.8709 |