National Provider Identifier [NPI]: |
1568436186 |
Last Name Of The Provider |
THOMAS |
First Name Of The Provider |
STUART |
Middle Initial Of The Provider |
J |
Credentials Of The Provider |
OD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1077 BAXTER ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
ATHENS |
Zip Code Of The Provider |
306063767 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
15 |
Number Of Services |
669 |
Number Of Medicare Beneficiaries |
347 |
Total Submitted Charge Amount |
72516 |
Total Medicare Allowed Amount |
58675.22 |
Total Medicare Payment Amount |
38738.55 |
Total Medicare Standardized Payment Amount |
45798.06 |
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 |
15 |
Number Of Medical Services |
669 |
Number Of Medicare Beneficiaries With Medical Services |
347 |
Total Medical Submitted Charge Amount |
72516 |
Total Medical Medicare Allowed Amount |
58675.22 |
Total Medical Medicare Payment Amount |
38738.55 |
Total Medical Medicare Standardized Payment Amount |
45798.06 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
23 |
Number Of Beneficiaries Age 65 to 74 |
187 |
Number Of Beneficiaries Age 75 to 84 |
106 |
Number Of Beneficiaries Age Greater 84 |
31 |
Number Of Female Beneficiaries |
193 |
Number Of Male Beneficiaries |
154 |
Number Of Non Hispanic White Beneficiaries |
271 |
Number Of Black or African American Beneficiaries |
|
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 |
|
Number Of Beneficiaries With Medicare Only Entitlement |
324 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
23 |
Percent Of With Atrial Fibrillation |
7 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
4 |
Percent Of With Cancer |
9 |
Percent Of With Heart Failure |
7 |
Percent Of With Chronic Kidney Disease |
20 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
15 |
Percent Of With Diabetes |
28 |
Percent Of With Hyperlipidemia |
52 |
Percent Of With Hypertension |
65 |
Percent Of With Ischemic Heart Disease |
24 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
37 |
Percent Of With Schizophrenia Other PsychoticDisorders |
0 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.8368 |