| National Provider Identifier [NPI]: | 1992766646 |
| Last Name Of The Provider | MIELKE |
| First Name Of The Provider | JOHN |
| Middle Initial Of The Provider | J |
| Credentials Of The Provider | O.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 801 S CHEVY CHASE DR |
| Street Address 2 Of The Provider | SUITE 103 |
| City Of The Provider | GLENDALE |
| Zip Code Of The Provider | 912054431 |
| State Code Of The Provider | CA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Optometry |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 4 |
| Number Of Services | 2697 |
| Number Of Medicare Beneficiaries | 2635 |
| Total Submitted Charge Amount | 774592 |
| Total Medicare Allowed Amount | 245918.48 |
| Total Medicare Payment Amount | 190310.43 |
| Total Medicare Standardized Payment Amount | 178075.35 |
| 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 | 4 |
| Number Of Medical Services | 2697 |
| Number Of Medicare Beneficiaries With Medical Services | 2635 |
| Total Medical Submitted Charge Amount | 774592 |
| Total Medical Medicare Allowed Amount | 245918.48 |
| Total Medical Medicare Payment Amount | 190310.43 |
| Total Medical Medicare Standardized Payment Amount | 178075.35 |
| Average Age Of Beneficiaries | 77 |
| Number Of Beneficiaries Age Less65 | 487 |
| Number Of Beneficiaries Age 65 to 74 | 559 |
| Number Of Beneficiaries Age 75 to 84 | 708 |
| Number Of Beneficiaries Age Greater 84 | 881 |
| Number Of Female Beneficiaries | 1487 |
| Number Of Male Beneficiaries | 1148 |
| Number Of Non Hispanic White Beneficiaries | 1187 |
| Number Of Black or African American Beneficiaries | 469 |
| Number Of AsianPacific Islander Beneficiaries | 253 |
| Number Of Hispanic Beneficiaries | 681 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 334 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 2301 |
| Percent Of With Atrial Fibrillation | 15 |
| Percent Of With Alzheimers Disease or Dementia | 65 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 8 |
| Percent Of With Heart Failure | 42 |
| Percent Of With Chronic Kidney Disease | 48 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 35 |
| Percent Of With Depression | 55 |
| Percent Of With Diabetes | 52 |
| Percent Of With Hyperlipidemia | 51 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 55 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 52 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 43 |
| Percent Of With Stroke | 16 |
| Average HCC Risk Score Of Beneficiaries | 2.8563 |