| National Provider Identifier [NPI]: | 1568459469 |
| Last Name Of The Provider | NICHOLS |
| First Name Of The Provider | STEPHEN |
| Middle Initial Of The Provider | L |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 7504 ANTIOCH RD |
| Street Address 2 Of The Provider | |
| City Of The Provider | OVERLAND PARK |
| Zip Code Of The Provider | 662042622 |
| State Code Of The Provider | KS |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 20 |
| Number Of Services | 1429 |
| Number Of Medicare Beneficiaries | 990 |
| Total Submitted Charge Amount | 232395 |
| Total Medicare Allowed Amount | 142243.02 |
| Total Medicare Payment Amount | 91385.14 |
| Total Medicare Standardized Payment Amount | 99700.96 |
| 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 | 20 |
| Number Of Medical Services | 1429 |
| Number Of Medicare Beneficiaries With Medical Services | 990 |
| Total Medical Submitted Charge Amount | 232395 |
| Total Medical Medicare Allowed Amount | 142243.02 |
| Total Medical Medicare Payment Amount | 91385.14 |
| Total Medical Medicare Standardized Payment Amount | 99700.96 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 48 |
| Number Of Beneficiaries Age 65 to 74 | 475 |
| Number Of Beneficiaries Age 75 to 84 | 298 |
| Number Of Beneficiaries Age Greater 84 | 169 |
| Number Of Female Beneficiaries | 608 |
| Number Of Male Beneficiaries | 382 |
| Number Of Non Hispanic White Beneficiaries | 937 |
| Number Of Black or African American Beneficiaries | 18 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 15 |
| Number Of Beneficiaries With Medicare Only Entitlement | 969 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 21 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 6 |
| Percent Of With Asthma | 5 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 11 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 8 |
| Percent Of With Depression | 13 |
| Percent Of With Diabetes | 22 |
| Percent Of With Hyperlipidemia | 55 |
| Percent Of With Hypertension | 60 |
| Percent Of With Ischemic Heart Disease | 29 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 2 |
| Percent Of With Stroke | 4 |
| Average HCC Risk Score Of Beneficiaries | 0.9083 |