National Provider Identifier [NPI]: |
1881761393 |
Last Name Of The Provider |
BRENART |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
W |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
120 E COUNTRYSIDE PKWY |
Street Address 2 Of The Provider |
|
City Of The Provider |
YORKVILLE |
Zip Code Of The Provider |
605601877 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
29 |
Number Of Services |
5730 |
Number Of Medicare Beneficiaries |
433 |
Total Submitted Charge Amount |
107495.3 |
Total Medicare Allowed Amount |
88303.15 |
Total Medicare Payment Amount |
60827.14 |
Total Medicare Standardized Payment Amount |
64363.22 |
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 |
29 |
Number Of Medical Services |
5730 |
Number Of Medicare Beneficiaries With Medical Services |
433 |
Total Medical Submitted Charge Amount |
107495.3 |
Total Medical Medicare Allowed Amount |
88303.15 |
Total Medical Medicare Payment Amount |
60827.14 |
Total Medical Medicare Standardized Payment Amount |
64363.22 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
22 |
Number Of Beneficiaries Age 65 to 74 |
198 |
Number Of Beneficiaries Age 75 to 84 |
145 |
Number Of Beneficiaries Age Greater 84 |
68 |
Number Of Female Beneficiaries |
256 |
Number Of Male Beneficiaries |
177 |
Number Of Non Hispanic White Beneficiaries |
416 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
394 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
39 |
Percent Of With Atrial Fibrillation |
14 |
Percent Of With Alzheimers Disease or Dementia |
7 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
22 |
Percent Of With Chronic Obstructive Pulmonary Disease |
9 |
Percent Of With Depression |
14 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
62 |
Percent Of With Hypertension |
69 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
9 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
38 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9516 |