National Provider Identifier [NPI]: |
1013989441 |
Last Name Of The Provider |
SAETRE |
First Name Of The Provider |
SIV |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1230 E RUSHOLME ST |
Street Address 2 Of The Provider |
STE 203 |
City Of The Provider |
DAVENPORT |
Zip Code Of The Provider |
528032400 |
State Code Of The Provider |
IA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Ophthalmology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
44 |
Number Of Services |
4647 |
Number Of Medicare Beneficiaries |
1782 |
Total Submitted Charge Amount |
1402477.5 |
Total Medicare Allowed Amount |
621607.45 |
Total Medicare Payment Amount |
442221.99 |
Total Medicare Standardized Payment Amount |
484976.06 |
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 |
44 |
Number Of Medical Services |
4647 |
Number Of Medicare Beneficiaries With Medical Services |
1782 |
Total Medical Submitted Charge Amount |
1402477.5 |
Total Medical Medicare Allowed Amount |
621607.45 |
Total Medical Medicare Payment Amount |
442221.99 |
Total Medical Medicare Standardized Payment Amount |
484976.06 |
Average Age Of Beneficiaries |
77 |
Number Of Beneficiaries Age Less65 |
51 |
Number Of Beneficiaries Age 65 to 74 |
628 |
Number Of Beneficiaries Age 75 to 84 |
734 |
Number Of Beneficiaries Age Greater 84 |
369 |
Number Of Female Beneficiaries |
1132 |
Number Of Male Beneficiaries |
650 |
Number Of Non Hispanic White Beneficiaries |
1667 |
Number Of Black or African American Beneficiaries |
61 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
31 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
1685 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
97 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
11 |
Percent Of With Heart Failure |
12 |
Percent Of With Chronic Kidney Disease |
18 |
Percent Of With Chronic Obstructive Pulmonary Disease |
11 |
Percent Of With Depression |
13 |
Percent Of With Diabetes |
27 |
Percent Of With Hyperlipidemia |
56 |
Percent Of With Hypertension |
64 |
Percent Of With Ischemic Heart Disease |
31 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
32 |
Percent Of With Schizophrenia Other PsychoticDisorders |
2 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.0241 |