National Provider Identifier [NPI]: |
1508868795 |
Last Name Of The Provider |
HONSON |
First Name Of The Provider |
MATTHEW |
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 |
5202 FARAON ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
SAINT JOSEPH |
Zip Code Of The Provider |
645063809 |
State Code Of The Provider |
MO |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Optometry |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
23 |
Number Of Services |
1125 |
Number Of Medicare Beneficiaries |
809 |
Total Submitted Charge Amount |
144614 |
Total Medicare Allowed Amount |
106736.03 |
Total Medicare Payment Amount |
71251.84 |
Total Medicare Standardized Payment Amount |
80127.9 |
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 |
23 |
Number Of Medical Services |
1125 |
Number Of Medicare Beneficiaries With Medical Services |
809 |
Total Medical Submitted Charge Amount |
144614 |
Total Medical Medicare Allowed Amount |
106736.03 |
Total Medical Medicare Payment Amount |
71251.84 |
Total Medical Medicare Standardized Payment Amount |
80127.9 |
Average Age Of Beneficiaries |
71 |
Number Of Beneficiaries Age Less65 |
127 |
Number Of Beneficiaries Age 65 to 74 |
382 |
Number Of Beneficiaries Age 75 to 84 |
202 |
Number Of Beneficiaries Age Greater 84 |
98 |
Number Of Female Beneficiaries |
481 |
Number Of Male Beneficiaries |
328 |
Number Of Non Hispanic White Beneficiaries |
778 |
Number Of Black or African American Beneficiaries |
12 |
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 |
692 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
117 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
6 |
Percent Of With Asthma |
5 |
Percent Of With Cancer |
10 |
Percent Of With Heart Failure |
9 |
Percent Of With Chronic Kidney Disease |
12 |
Percent Of With Chronic Obstructive Pulmonary Disease |
15 |
Percent Of With Depression |
20 |
Percent Of With Diabetes |
29 |
Percent Of With Hyperlipidemia |
57 |
Percent Of With Hypertension |
62 |
Percent Of With Ischemic Heart Disease |
28 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
36 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
3 |
Average HCC Risk Score Of Beneficiaries |
0.9376 |