National Provider Identifier [NPI]: |
1114913761 |
Last Name Of The Provider |
TRENT |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
G |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
3190 CHURN CREEK RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
REDDING |
Zip Code Of The Provider |
960022122 |
State Code Of The Provider |
CA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
61 |
Number Of Services |
9852 |
Number Of Medicare Beneficiaries |
1788 |
Total Submitted Charge Amount |
3083399 |
Total Medicare Allowed Amount |
1665427.69 |
Total Medicare Payment Amount |
1260890.52 |
Total Medicare Standardized Payment Amount |
1223842.3 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
7 |
Number Of Drug Services |
1308 |
Number Of Medicare Beneficiaries With Drug Services |
218 |
Total Drug Submitted ChargeAmount |
803869 |
Total Drug Medicare AllowedAmount |
614655.81 |
Total Drug Medicare PaymentAmount |
479491.81 |
Total Drug Medicare Standardized Payment Amount |
479491.81 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
54 |
Number Of Medical Services |
8544 |
Number Of Medicare Beneficiaries With Medical Services |
1788 |
Total Medical Submitted Charge Amount |
2279530 |
Total Medical Medicare Allowed Amount |
1050771.88 |
Total Medical Medicare Payment Amount |
781398.71 |
Total Medical Medicare Standardized Payment Amount |
744350.49 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
136 |
Number Of Beneficiaries Age 65 to 74 |
749 |
Number Of Beneficiaries Age 75 to 84 |
600 |
Number Of Beneficiaries Age Greater 84 |
303 |
Number Of Female Beneficiaries |
1079 |
Number Of Male Beneficiaries |
709 |
Number Of Non Hispanic White Beneficiaries |
1620 |
Number Of Black or African American Beneficiaries |
11 |
Number Of AsianPacific Islander Beneficiaries |
17 |
Number Of Hispanic Beneficiaries |
60 |
Number Of American Indian Alaska Native Beneficiaries |
69 |
Number Of Beneficiaries With Race Not Else where Classified |
11 |
Number Of Beneficiaries With Medicare Only Entitlement |
1513 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
275 |
Percent Of With Atrial Fibrillation |
12 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
15 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
13 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
38 |
Percent Of With Hyperlipidemia |
50 |
Percent Of With Hypertension |
59 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.0998 |