| National Provider Identifier [NPI]: | 1285788745 |
| Last Name Of The Provider | HEDDLE |
| First Name Of The Provider | GEOFFREY |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | OD |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 2047 NILES ROAD |
| Street Address 2 Of The Provider | |
| City Of The Provider | SANT JOSEPH |
| Zip Code Of The Provider | 490852505 |
| 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 | 8 |
| Number Of Services | 273 |
| Number Of Medicare Beneficiaries | 212 |
| Total Submitted Charge Amount | 28396.63 |
| Total Medicare Allowed Amount | 28324.42 |
| Total Medicare Payment Amount | 22182.79 |
| Total Medicare Standardized Payment Amount | 23410.45 |
| 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 | 8 |
| Number Of Medical Services | 273 |
| Number Of Medicare Beneficiaries With Medical Services | 212 |
| Total Medical Submitted Charge Amount | 28396.63 |
| Total Medical Medicare Allowed Amount | 28324.42 |
| Total Medical Medicare Payment Amount | 22182.79 |
| Total Medical Medicare Standardized Payment Amount | 23410.45 |
| Average Age Of Beneficiaries | 79 |
| Number Of Beneficiaries Age Less65 | 31 |
| Number Of Beneficiaries Age 65 to 74 | 41 |
| Number Of Beneficiaries Age 75 to 84 | 60 |
| Number Of Beneficiaries Age Greater 84 | 80 |
| Number Of Female Beneficiaries | 131 |
| Number Of Male Beneficiaries | 81 |
| Number Of Non Hispanic White Beneficiaries | 175 |
| 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 | 11 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 201 |
| Percent Of With Atrial Fibrillation | 17 |
| Percent Of With Alzheimers Disease or Dementia | 75 |
| Percent Of With Asthma | |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 37 |
| Percent Of With Chronic Kidney Disease | 39 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 25 |
| Percent Of With Depression | 61 |
| Percent Of With Diabetes | 49 |
| Percent Of With Hyperlipidemia | 40 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 33 |
| Percent Of With Osteoporosis | 15 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 35 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 44 |
| Percent Of With Stroke | 23 |
| Average HCC Risk Score Of Beneficiaries | 2.3367 |