National Provider Identifier [NPI]: |
1134210123 |
Last Name Of The Provider |
GREGORY |
First Name Of The Provider |
JOSEPH |
Middle Initial Of The Provider |
E |
Credentials Of The Provider |
O.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
5405 INDIAN HILL BLVD |
Street Address 2 Of The Provider |
|
City Of The Provider |
DIAMONDHEAD |
Zip Code Of The Provider |
395253324 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
18 |
Number Of Services |
703 |
Number Of Medicare Beneficiaries |
239 |
Total Submitted Charge Amount |
51198.85 |
Total Medicare Allowed Amount |
50083.33 |
Total Medicare Payment Amount |
34254.59 |
Total Medicare Standardized Payment Amount |
37625.76 |
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 |
18 |
Number Of Medical Services |
703 |
Number Of Medicare Beneficiaries With Medical Services |
239 |
Total Medical Submitted Charge Amount |
51198.85 |
Total Medical Medicare Allowed Amount |
50083.33 |
Total Medical Medicare Payment Amount |
34254.59 |
Total Medical Medicare Standardized Payment Amount |
37625.76 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
39 |
Number Of Beneficiaries Age 65 to 74 |
100 |
Number Of Beneficiaries Age 75 to 84 |
73 |
Number Of Beneficiaries Age Greater 84 |
27 |
Number Of Female Beneficiaries |
154 |
Number Of Male Beneficiaries |
85 |
Number Of Non Hispanic White Beneficiaries |
214 |
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 |
185 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
54 |
Percent Of With Atrial Fibrillation |
10 |
Percent Of With Alzheimers Disease or Dementia |
8 |
Percent Of With Asthma |
6 |
Percent Of With Cancer |
8 |
Percent Of With Heart Failure |
18 |
Percent Of With Chronic Kidney Disease |
21 |
Percent Of With Chronic Obstructive Pulmonary Disease |
21 |
Percent Of With Depression |
18 |
Percent Of With Diabetes |
32 |
Percent Of With Hyperlipidemia |
55 |
Percent Of With Hypertension |
70 |
Percent Of With Ischemic Heart Disease |
38 |
Percent Of With Osteoporosis |
8 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
|
Percent Of With Stroke |
5 |
Average HCC Risk Score Of Beneficiaries |
1.1441 |