| National Provider Identifier [NPI]: | 1891703500 |
| Last Name Of The Provider | CORNBLATH |
| First Name Of The Provider | WAYNE |
| Middle Initial Of The Provider | T |
| Credentials Of The Provider | MD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1000 WALL ST |
| Street Address 2 Of The Provider | |
| City Of The Provider | ANN ARBOR |
| Zip Code Of The Provider | 481051912 |
| State Code Of The Provider | MI |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Ophthalmology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 33 |
| Number Of Services | 1206 |
| Number Of Medicare Beneficiaries | 505 |
| Total Submitted Charge Amount | 383676 |
| Total Medicare Allowed Amount | 129725.74 |
| Total Medicare Payment Amount | 93153.2 |
| Total Medicare Standardized Payment Amount | 79253.3 |
| 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 | 33 |
| Number Of Medical Services | 1206 |
| Number Of Medicare Beneficiaries With Medical Services | 505 |
| Total Medical Submitted Charge Amount | 383676 |
| Total Medical Medicare Allowed Amount | 129725.74 |
| Total Medical Medicare Payment Amount | 93153.2 |
| Total Medical Medicare Standardized Payment Amount | 79253.3 |
| Average Age Of Beneficiaries | 67 |
| Number Of Beneficiaries Age Less65 | 155 |
| Number Of Beneficiaries Age 65 to 74 | 181 |
| Number Of Beneficiaries Age 75 to 84 | 132 |
| Number Of Beneficiaries Age Greater 84 | 37 |
| Number Of Female Beneficiaries | 334 |
| Number Of Male Beneficiaries | 171 |
| Number Of Non Hispanic White Beneficiaries | 435 |
| Number Of Black or African American Beneficiaries | 37 |
| Number Of AsianPacific Islander Beneficiaries | 12 |
| 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 | 396 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 109 |
| Percent Of With Atrial Fibrillation | 10 |
| Percent Of With Alzheimers Disease or Dementia | 10 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 10 |
| Percent Of With Heart Failure | 16 |
| Percent Of With Chronic Kidney Disease | 15 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 12 |
| Percent Of With Depression | 30 |
| Percent Of With Diabetes | 27 |
| Percent Of With Hyperlipidemia | 47 |
| Percent Of With Hypertension | 59 |
| Percent Of With Ischemic Heart Disease | 31 |
| Percent Of With Osteoporosis | 8 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 38 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 10 |
| Average HCC Risk Score Of Beneficiaries | 1.2565 |