| National Provider Identifier [NPI]: | 1013907492 |
| Last Name Of The Provider | MARVIN |
| First Name Of The Provider | PAUL |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | OD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 135 S SHARON AMITY RD |
| Street Address 2 Of The Provider | SUITE 100 |
| City Of The Provider | CHARLOTTE |
| Zip Code Of The Provider | 282112842 |
| State Code Of The Provider | NC |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 21 |
| Number Of Services | 649 |
| Number Of Medicare Beneficiaries | 497 |
| Total Submitted Charge Amount | 124245 |
| Total Medicare Allowed Amount | 62117.2 |
| Total Medicare Payment Amount | 39588.89 |
| Total Medicare Standardized Payment Amount | 42465.97 |
| 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 | 21 |
| Number Of Medical Services | 649 |
| Number Of Medicare Beneficiaries With Medical Services | 497 |
| Total Medical Submitted Charge Amount | 124245 |
| Total Medical Medicare Allowed Amount | 62117.2 |
| Total Medical Medicare Payment Amount | 39588.89 |
| Total Medical Medicare Standardized Payment Amount | 42465.97 |
| Average Age Of Beneficiaries | 73 |
| Number Of Beneficiaries Age Less65 | 40 |
| Number Of Beneficiaries Age 65 to 74 | 271 |
| Number Of Beneficiaries Age 75 to 84 | 120 |
| Number Of Beneficiaries Age Greater 84 | 66 |
| Number Of Female Beneficiaries | 316 |
| Number Of Male Beneficiaries | 181 |
| Number Of Non Hispanic White Beneficiaries | 419 |
| Number Of Black or African American Beneficiaries | 48 |
| Number Of AsianPacific Islander Beneficiaries | 11 |
| 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 | 439 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 58 |
| Percent Of With Atrial Fibrillation | 8 |
| Percent Of With Alzheimers Disease or Dementia | 7 |
| Percent Of With Asthma | 6 |
| Percent Of With Cancer | 9 |
| Percent Of With Heart Failure | 10 |
| Percent Of With Chronic Kidney Disease | 14 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 9 |
| Percent Of With Depression | 14 |
| Percent Of With Diabetes | 19 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 52 |
| Percent Of With Ischemic Heart Disease | 21 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 30 |
| Percent Of With Schizophrenia Other PsychoticDisorders | |
| Percent Of With Stroke | 5 |
| Average HCC Risk Score Of Beneficiaries | 0.9543 |