National Provider Identifier [NPI]: |
1285652032 |
Last Name Of The Provider |
TRAN |
First Name Of The Provider |
STANLEY |
Middle Initial Of The Provider |
T |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5900 COIT RD |
Street Address 2 Of The Provider |
|
City Of The Provider |
PLANO |
Zip Code Of The Provider |
750235959 |
State Code Of The Provider |
TX |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
598 |
Number Of Medicare Beneficiaries |
264 |
Total Submitted Charge Amount |
64920 |
Total Medicare Allowed Amount |
53603.93 |
Total Medicare Payment Amount |
36415.25 |
Total Medicare Standardized Payment Amount |
38993.09 |
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 |
17 |
Number Of Medical Services |
598 |
Number Of Medicare Beneficiaries With Medical Services |
264 |
Total Medical Submitted Charge Amount |
64920 |
Total Medical Medicare Allowed Amount |
53603.93 |
Total Medical Medicare Payment Amount |
36415.25 |
Total Medical Medicare Standardized Payment Amount |
38993.09 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
|
Number Of Beneficiaries Age 65 to 74 |
162 |
Number Of Beneficiaries Age 75 to 84 |
70 |
Number Of Beneficiaries Age Greater 84 |
|
Number Of Female Beneficiaries |
173 |
Number Of Male Beneficiaries |
91 |
Number Of Non Hispanic White Beneficiaries |
222 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
21 |
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 |
226 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
38 |
Percent Of With Atrial Fibrillation |
6 |
Percent Of With Alzheimers Disease or Dementia |
5 |
Percent Of With Asthma |
|
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
|
Percent Of With Depression |
13 |
Percent Of With Diabetes |
26 |
Percent Of With Hyperlipidemia |
61 |
Percent Of With Hypertension |
60 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.8081 |