National Provider Identifier [NPI]: |
1730109216 |
Last Name Of The Provider |
LAZARTE |
First Name Of The Provider |
RICHARD |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5488 S PADRE ISLAND DR STE 2042 |
Street Address 2 Of The Provider |
|
City Of The Provider |
CORPUS CHRISTI |
Zip Code Of The Provider |
784114122 |
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 |
13 |
Number Of Services |
250 |
Number Of Medicare Beneficiaries |
198 |
Total Submitted Charge Amount |
33962.68 |
Total Medicare Allowed Amount |
27324.57 |
Total Medicare Payment Amount |
18339.16 |
Total Medicare Standardized Payment Amount |
19996 |
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 |
13 |
Number Of Medical Services |
250 |
Number Of Medicare Beneficiaries With Medical Services |
198 |
Total Medical Submitted Charge Amount |
33962.68 |
Total Medical Medicare Allowed Amount |
27324.57 |
Total Medical Medicare Payment Amount |
18339.16 |
Total Medical Medicare Standardized Payment Amount |
19996 |
Average Age Of Beneficiaries |
69 |
Number Of Beneficiaries Age Less65 |
56 |
Number Of Beneficiaries Age 65 to 74 |
64 |
Number Of Beneficiaries Age 75 to 84 |
56 |
Number Of Beneficiaries Age Greater 84 |
22 |
Number Of Female Beneficiaries |
109 |
Number Of Male Beneficiaries |
89 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
101 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
131 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
67 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
8 |
Percent Of With Cancer |
|
Percent Of With Heart Failure |
21 |
Percent Of With Chronic Kidney Disease |
26 |
Percent Of With Chronic Obstructive Pulmonary Disease |
12 |
Percent Of With Depression |
22 |
Percent Of With Diabetes |
45 |
Percent Of With Hyperlipidemia |
63 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
40 |
Percent Of With Osteoporosis |
10 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
39 |
Percent Of With Schizophrenia Other PsychoticDisorders |
7 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
1.2907 |