National Provider Identifier [NPI]: |
1295060374 |
Last Name Of The Provider |
MCCARRELL |
First Name Of The Provider |
JESSE |
Middle Initial Of The Provider |
Q |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
820 N CHELAN AVE |
Street Address 2 Of The Provider |
|
City Of The Provider |
WENATCHEE |
Zip Code Of The Provider |
988012028 |
State Code Of The Provider |
WA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
24 |
Number Of Services |
909 |
Number Of Medicare Beneficiaries |
597 |
Total Submitted Charge Amount |
116164.76 |
Total Medicare Allowed Amount |
61005.3 |
Total Medicare Payment Amount |
39314.99 |
Total Medicare Standardized Payment Amount |
41769.41 |
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 |
24 |
Number Of Medical Services |
909 |
Number Of Medicare Beneficiaries With Medical Services |
597 |
Total Medical Submitted Charge Amount |
116164.76 |
Total Medical Medicare Allowed Amount |
61005.3 |
Total Medical Medicare Payment Amount |
39314.99 |
Total Medical Medicare Standardized Payment Amount |
41769.41 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
101 |
Number Of Beneficiaries Age 65 to 74 |
260 |
Number Of Beneficiaries Age 75 to 84 |
159 |
Number Of Beneficiaries Age Greater 84 |
77 |
Number Of Female Beneficiaries |
321 |
Number Of Male Beneficiaries |
276 |
Number Of Non Hispanic White Beneficiaries |
534 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
47 |
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
467 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
130 |
Percent Of With Atrial Fibrillation |
11 |
Percent Of With Alzheimers Disease or Dementia |
9 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
13 |
Percent Of With Chronic Kidney Disease |
25 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
27 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
47 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
26 |
Percent Of With Osteoporosis |
5 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
34 |
Percent Of With Schizophrenia Other PsychoticDisorders |
3 |
Percent Of With Stroke |
4 |
Average HCC Risk Score Of Beneficiaries |
1.2013 |