National Provider Identifier [NPI]: |
1396058194 |
Last Name Of The Provider |
STURGILL |
First Name Of The Provider |
SARAH |
Middle Initial Of The Provider |
C |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
600 N LOGAN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
DANVILLE |
Zip Code Of The Provider |
618324375 |
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 |
19 |
Number Of Services |
1441 |
Number Of Medicare Beneficiaries |
913 |
Total Submitted Charge Amount |
164599.82 |
Total Medicare Allowed Amount |
130103.54 |
Total Medicare Payment Amount |
84713.19 |
Total Medicare Standardized Payment Amount |
87611.48 |
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 |
19 |
Number Of Medical Services |
1441 |
Number Of Medicare Beneficiaries With Medical Services |
913 |
Total Medical Submitted Charge Amount |
164599.82 |
Total Medical Medicare Allowed Amount |
130103.54 |
Total Medical Medicare Payment Amount |
84713.19 |
Total Medical Medicare Standardized Payment Amount |
87611.48 |
Average Age Of Beneficiaries |
75 |
Number Of Beneficiaries Age Less65 |
34 |
Number Of Beneficiaries Age 65 to 74 |
424 |
Number Of Beneficiaries Age 75 to 84 |
314 |
Number Of Beneficiaries Age Greater 84 |
141 |
Number Of Female Beneficiaries |
535 |
Number Of Male Beneficiaries |
378 |
Number Of Non Hispanic White Beneficiaries |
815 |
Number Of Black or African American Beneficiaries |
28 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
50 |
Number Of American Indian Alaska Native Beneficiaries |
0 |
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
858 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
55 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
16 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
54 |
Percent Of With Hypertension |
63 |
Percent Of With Ischemic Heart Disease |
30 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
1 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
0.9807 |