| National Provider Identifier [NPI]: | 1790973956 |
| Last Name Of The Provider | ANDERSON |
| First Name Of The Provider | TIMOTHY |
| Middle Initial Of The Provider | D |
| Credentials Of The Provider | OD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3127 ROYAL HANNA DR NE |
| Street Address 2 Of The Provider | |
| City Of The Provider | ROCKFORD |
| Zip Code Of The Provider | 493417525 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 10 |
| Number Of Services | 4650 |
| Number Of Medicare Beneficiaries | 2117 |
| Total Submitted Charge Amount | 547670.92 |
| Total Medicare Allowed Amount | 491565.28 |
| Total Medicare Payment Amount | 349363.17 |
| Total Medicare Standardized Payment Amount | 368641.93 |
| 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 | 10 |
| Number Of Medical Services | 4650 |
| Number Of Medicare Beneficiaries With Medical Services | 2117 |
| Total Medical Submitted Charge Amount | 547670.92 |
| Total Medical Medicare Allowed Amount | 491565.28 |
| Total Medical Medicare Payment Amount | 349363.17 |
| Total Medical Medicare Standardized Payment Amount | 368641.93 |
| Average Age Of Beneficiaries | 81 |
| Number Of Beneficiaries Age Less65 | 209 |
| Number Of Beneficiaries Age 65 to 74 | 335 |
| Number Of Beneficiaries Age 75 to 84 | 585 |
| Number Of Beneficiaries Age Greater 84 | 988 |
| Number Of Female Beneficiaries | 1519 |
| Number Of Male Beneficiaries | 598 |
| Number Of Non Hispanic White Beneficiaries | 1823 |
| Number Of Black or African American Beneficiaries | 217 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 44 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 16 |
| Number Of Beneficiaries With Medicare Only Entitlement | 162 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 1955 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 50 |
| Percent Of With Chronic Kidney Disease | 41 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 29 |
| Percent Of With Depression | 61 |
| Percent Of With Diabetes | 47 |
| Percent Of With Hyperlipidemia | 44 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 48 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 62 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 28 |
| Percent Of With Stroke | 17 |
| Average HCC Risk Score Of Beneficiaries | 2.444 |