| National Provider Identifier [NPI]: | 1205817392 |
| Last Name Of The Provider | FOREMAN |
| First Name Of The Provider | RONALD |
| Middle Initial Of The Provider | R |
| Credentials Of The Provider | OD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 763 SW MAIN BLVD |
| Street Address 2 Of The Provider | |
| City Of The Provider | LAKE CITY |
| Zip Code Of The Provider | 320255791 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 27 |
| Number Of Services | 997 |
| Number Of Medicare Beneficiaries | 582 |
| Total Submitted Charge Amount | 90339 |
| Total Medicare Allowed Amount | 78117.81 |
| Total Medicare Payment Amount | 52928.41 |
| Total Medicare Standardized Payment Amount | 54133.73 |
| 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 | 27 |
| Number Of Medical Services | 997 |
| Number Of Medicare Beneficiaries With Medical Services | 582 |
| Total Medical Submitted Charge Amount | 90339 |
| Total Medical Medicare Allowed Amount | 78117.81 |
| Total Medical Medicare Payment Amount | 52928.41 |
| Total Medical Medicare Standardized Payment Amount | 54133.73 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 52 |
| Number Of Beneficiaries Age 65 to 74 | 275 |
| Number Of Beneficiaries Age 75 to 84 | 196 |
| Number Of Beneficiaries Age Greater 84 | 59 |
| Number Of Female Beneficiaries | 383 |
| Number Of Male Beneficiaries | 199 |
| Number Of Non Hispanic White Beneficiaries | 489 |
| Number Of Black or African American Beneficiaries | 78 |
| 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 | 468 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 114 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 8 |
| Percent Of With Asthma | 8 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 20 |
| Percent Of With Chronic Kidney Disease | 23 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 19 |
| Percent Of With Depression | 18 |
| Percent Of With Diabetes | 34 |
| Percent Of With Hyperlipidemia | 67 |
| Percent Of With Hypertension | 74 |
| Percent Of With Ischemic Heart Disease | 41 |
| Percent Of With Osteoporosis | 10 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 40 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 3 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 1.1264 |